Shore Community Medical LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

C10006041 Issued in DE

Legal business name

SHORE COMMUNITY MEDICAL LLC

Practice address

18947 John J Williams Hwy
Suite 306
Rehoboth Beach, DE 19971-4474

Phone

(302) 827-4365

Fax

(302) 827-4359

NPI assigned

Sep 4, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Francis Kelly, M.D.

Title

Member

Phone

(302) 827-4365

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1315094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326326400000",
    "number": "1740561778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18947 JOHN J WILLIAMS HWY",
            "address_2": "SUITE NUMBER 306",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199714474",
            "telephone_number": "302-827-4365",
            "fax_number": "302-827-4359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18947 JOHN J WILLIAMS HWY",
            "address_2": "SUITE 306",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199714474",
            "telephone_number": "302-827-4365",
            "fax_number": "302-827-4359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE COMMUNITY MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-04",
        "last_updated": "2012-01-12",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "302-827-4365",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C10006041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Rehoboth Beach, DE
• Providers in Rehoboth Beach, DE by specialty
• Internal Medicine Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; 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.