Individual provider Active NPI

Kim Alexzenia Kelly - Robinson, M.D.

  • Pediatrics Physician
  • Suitland, MD
National Provider Identifier
1699848754
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0039363 Issued in MD
Practice address
5875 Allentown Rd
Suitland, MD 20746-4570
Phone
(301) 702-2003
Fax
(301) 702-2324
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0039363 MD Primary

Addresses

Primary practice location

5875 Allentown Rd
Suitland, MD 20746-4570

Mailing address

5875 Allentown Rd
Suitland, MD 20746-4570
Phone (301) 702-2003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0039363MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kim a Kelly, M.D., P.C. Current Accepting new patients
Kim a Kelly, M.D., P.C. Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

5875 Allentown Rd
Suitland, MD 20746
Phone (301) 702-2003

Interoperability endpoints

  • Direct secure messaging: kim.kelly.robinson.1@9428.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/9428/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1699848754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5875 ALLENTOWN RD",
            "city": "SUITLAND",
            "state": "MD",
            "postal_code": "207464570",
            "telephone_number": "301-702-2003",
            "fax_number": "301-702-2324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5875 ALLENTOWN RD",
            "city": "SUITLAND",
            "state": "MD",
            "postal_code": "207464570",
            "telephone_number": "301-702-2003",
            "fax_number": "301-702-2324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY - ROBINSON",
        "first_name": "KIM",
        "middle_name": "ALEXZENIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0039363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suitland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; 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.