Christopher P Kelly, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

9258138-1205 Issued in UT

Practice address

11464 S Parkway Plaza Dr Ste 300
South Jordan, UT 84095-6053

Phone

(801) 987-8653

NPI assigned

Feb 16, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515369600000",
    "number": "1720122583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11464 S PARKWAY PLAZA DR STE 300",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840956053",
            "telephone_number": "801-987-8653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11464 S PARKWAY PLAZA DR STE 300",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840956053",
            "telephone_number": "801-987-8653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CHRISTOPHER",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2018-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "UT",
            "license": "9258138-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirstine Elizabeth Keel, CMHC
• Laura Kehler
• Joseph Keller
• Sarah Richele Kelley
• Stephanie Church Kelley, ACMHC
• Michelle R Kelly, LCSW
• Aidan Kemp
• Katherine Ann Kennedy
• Laura Rice Kenney, APRN
• Russell Kennington

• Plastic and Reconstructive Surgery Physician in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Plastic and Reconstructive Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2018; 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.