William Patrick Kelsey V

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

6632 Issued in NE

Practice address

17785 Mason St
Suite 103
Omaha, NE 68118-3526

Phone

(402) 934-4745

Fax

(402) 934-4760

NPI assigned

Jun 4, 2009

Last updated

Jun 4, 2009By 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 NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Kelsey Periodontal Group, LLC

  • Dental Clinic/Center
  • Omaha, NE
  • NPI 1831423177
  NPD (past) Authorized official

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244073600000",
    "number": "1730315714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17785 MASON ST",
            "address_2": "SUITE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681183526",
            "telephone_number": "402-934-4745",
            "fax_number": "402-934-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17785 MASON ST",
            "address_2": "SUITE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681183526",
            "telephone_number": "402-934-4745",
            "fax_number": "402-934-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSEY",
        "first_name": "WILLIAM",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "name_suffix": "V",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-04",
        "last_updated": "2009-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NE",
            "license": "6632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy Sue Kelsey, RN
• Mary Nan Kelsey IV, D.D.S.
• Matthew Ryan Kelsey, D.D.S., M.S.
• Sara Jeannette Kelsey, RD, LMNT
• Tiffani L Kelsey
• William Patrick Kelsey III, D.D.S.
• Shania Kelso
• Jayson Kemble, DO
• Kaitlan G Kemler
• Adam Joseph Kemp

• Periodontics in Omaha, NE
• Providers in Omaha, NE by specialty
• Periodontics in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; 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.