Simon Paul Kelley, MBCHB, PHD, FRCS

Primary specialty

Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X

License

48300 Issued in TX

Practice address

6701 Fannin Street
Suite D.0650.15
Houston, TX 77030

Phone

(713) 447-6934

NPI assigned

Oct 8, 2024

Last updated

Oct 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Texas Children's Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506
  Medicare reassignment NPD

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1710706635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 DUNSTAN RD",
            "address_2": "APT 420",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77005",
            "telephone_number": "647-239-6354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 FANNIN STREET",
            "address_2": "SUITE D.0650.15",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "713-447-6934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "SIMON",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MBCHB, PHD, FRCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "TX",
            "license": "48300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew E Kelley
• Megan Elizabeth Kelley
• Paul Kelley
• Rayshard Kelley
• Richanne L Kelley, APRN, CWCN, FNP-C
• Tyneshia Kelley
• Kelli L. Wright PHD PLLC
• Kellie's Sitting Services, Inc.
• Natasha Kellis, M.ED, BCBA, LBA
• Emily Kellogg, PHD

• Pediatric Orthopaedic Surgery Physician in Houston, TX
• Providers in Houston, TX by specialty
• Pediatric Orthopaedic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.