Neil Kelly, D.D. S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

015230 Issued in MO

Practice address

400 E Red Bridge Rd
Suite 119
Kansas City, MO 64131-4035

Phone

(816) 942-8550

Fax

(816) 942-0790

NPI assigned

Apr 20, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

State licenses

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258070400000",
    "number": "1740407501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E RED BRIDGE RD",
            "address_2": "SUITE 119",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641314035",
            "telephone_number": "816-942-8550",
            "fax_number": "816-942-0790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E RED BRIDGE RD",
            "address_2": "SUITE 119",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641314035",
            "telephone_number": "816-942-8550",
            "fax_number": "816-942-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "NEIL",
        "name_prefix": "Dr.",
        "credential": "D.D. S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2009-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "KS6683",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "015230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karla Jean Kelly, CRNA
• Katherine Kelly
• Katherine Patterson Kelly, RN, MCCNS
• Kelly D Kelly, PLCSW
• Lakeisha Kelly
• Shannon Lorraine Kelly, APRN, WHNP-BC
• Sherilyn Kelly, APRN
• Theresa Ann Kelly, RPH
• Kels in-Home Services, LLC
• Kels in-Home Services, LLC

• General Practice Dentistry in Kansas City, MO
• Providers in Kansas City, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.