Robert Kelly, DC

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

9284 Issued in AZ

Practice address

3415 W Glendale Ave Ste 3a
Phoenix, AZ 85051-8484

Phone

(602) 889-9595

NPI assigned

Jun 6, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prasada Health Center LLCGroup PAC ID 8628460672, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Prasada Health Center LLC

  • General Practice Physician
  • Surprise, AZ
  • NPI 1508532458
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1689368235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17944 W PORT ROYALE LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853887586",
            "telephone_number": "385-212-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 W GLENDALE AVE STE 3A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850518484",
            "telephone_number": "602-889-9595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5030 W McDowell Rd Ste 10",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850353946",
            "country_code": "US",
            "telephone_number": "602-233-9595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ROBERT",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "AZ",
            "license": "9284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynne Folger Kelly, OTR/L
• Megan Cathleen Kelly, MD
• Olivia Nicole Kelly
• Pamela K Kelly, PA
• Richard L Kelly, M.D.
• Sandra Lynne-Walker Kelly, RN
• Scott Michael Kelly, MS, ATC, LAT
• Shana Kelly
• Sharon Ann Kelly, LCSW
• Tara Kelly, DPT

• Rehabilitation Chiropractor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Rehabilitation Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.