Individual provider Active NPI

Ryan Kelly, MD

  • Pediatrics Physician
  • Virginia Beach, VA
National Provider Identifier
1730883166
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101289461 Issued in VA
Practice address
2088 Princess Anne Rd
Virginia Beach, VA 23456-4014
Phone
(757) 668-6700
Fax
(757) 668-6680
NPI assigned
Mar 29, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101289461 VA Primary

Addresses

Primary practice location

2088 Princess Anne Rd
Virginia Beach, VA 23456-4014

Mailing address

2088 Princess Anne Rd
Virginia Beach, VA 23456-4014
Phone (757) 668-6700

Other practice location 1

2021 Concert Dr Ste 201
Virginia Beach, VA 23456-8083
Phone (757) 668-6700

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

LicenseStateTypeSpecialty
0101289461VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Medical Group Inc Pediatrics PastSince Dec 10, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1730883166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2088 PRINCESS ANNE RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234564014",
            "telephone_number": "757-668-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2088 PRINCESS ANNE RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234564014",
            "telephone_number": "757-668-6700",
            "fax_number": "757-668-6680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2021 Concert Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234568083",
            "country_code": "US",
            "telephone_number": "757-668-6700",
            "fax_number": "757-668-2855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-29",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101289461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; 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.