Mary Thalia Kelly, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

93-299 Issued in NM

Practice address

Internal Medicine
MSC 10-5550, 1 Unm
Albuquerque, NM 87131-0001

Phone

(505) 272-2147

NPI assigned

Jan 26, 2007

Last updated

Aug 28, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Molly Kelly Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1659427938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4808 MCMAHON BLVD NW",
            "address_2": "UNM WESTSIDE CLINIC",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87114",
            "telephone_number": "505-272-2900",
            "fax_number": "505-272-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "INTERNAL MEDICINE",
            "address_2": "MSC 10-5550, 1 UNM",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MARY",
        "middle_name": "THALIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "93-299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "KELLY",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• James Edward Breandan Kelly IV, MD
• Jeremiah F Kelly, M.D.
• Leslie Kelly, LPC
• Linda R Kelly, PHARMD PHC
• Maria Kelly
• Mollie (Leila) Kelly
• Patricia L Kelly, M.D.
• Robert J. Kelly, D.D.S.
• Shandy Kelly, RDMS
• Tara Kelly, CRNA

• Internal Medicine Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Internal Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.