Active NPI
John Daniel Kelly, M.D.
- Internal Medicine Physician
- Houston, TX
National Provider Identifier
1730324740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- N7442
- Practice address
- 2002 Holcombe Blvd
Houston, TX 77030-4211 - Phone
- (713) 791-1414
- NPI assigned
- Dec 4, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | A123809 | CA | |
| Internal Medicine Physician | 207R00000X | N7442 | TX | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
2002 Holcombe Blvd
Houston, TX 77030-4211
Mailing address
1 Hermann Museum Circle Dr
Apt 2114
Houston, TX 77004-7174
Other practice location 1
1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 547-5437
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N7442 | TX | MD | Internal Medicine Physician |
| A123809 | CA | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City & County of San Francisco | Current | Accepting new patients | |
| City and County of San Francisco | Current | Accepting new patients | |
| City & County of San Francisco | Current | Accepting new patients |
Locations
1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305
Interoperability endpoints
- jkelly@yourcarecommunity.org
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.
-
- Clinical Medical Laboratory
- San Francisco, CA
- NPI 1982737524
-
- Community Health/Public Health Clinical Nurse Specialist
- San Francisco, CA
- NPI 1609041060
-
- Methadone Clinic
- San Francisco, CA
- NPI 1578787925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709683200000",
"number": "1730324740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 HERMANN MUSEUM CIRCLE DR",
"address_2": "APT 2114",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770047174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2002 HOLCOMBE BLVD",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770304211",
"telephone_number": "713-791-1414"
}
],
"practiceLocations": [
{
"address_1": "1165 Montgomery Dr",
"address_purpose": "LOCATION",
"city": "Santa Rosa",
"state": "CA",
"postal_code": "954054801",
"country_code": "US",
"telephone_number": "707-547-5437",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KELLY",
"first_name": "JOHN",
"middle_name": "DANIEL",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-04",
"last_updated": "2024-03-06",
"certification_date": "2024-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "CA",
"license": "A123809",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "N7442",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.