Active NPI
Lawrence F.X. Kelly, M.D.
- Pediatrics Physician
- Reston, VA
National Provider Identifier
1700049186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0101020841
- Practice address
- 11445 Sunset Hills Rd
Reston, VA 20190-5276 - Phone
- (703) 709-1600
- NPI assigned
- Jul 7, 2008
- Last updated
- Jul 7, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0101020841 | VA | Primary |
Addresses
Primary practice location
11445 Sunset Hills Rd
Reston, VA 20190-5276
Mailing address
223 Falcon Ridge Rd
Great Falls, VA 22066-3518
Phone (703) 759-5737
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0101020841 | VA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215388800000",
"number": "1700049186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "223 FALCON RIDGE RD",
"city": "GREAT FALLS",
"state": "VA",
"postal_code": "220663518",
"telephone_number": "703-759-5737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11445 SUNSET HILLS RD",
"city": "RESTON",
"state": "VA",
"postal_code": "201905276",
"telephone_number": "703-709-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "LAWRENCE",
"middle_name": "F.X.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-07",
"last_updated": "2008-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0101020841",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.