Terry Michael Kelly, DMD

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DN11407 Issued in FL

Practice address

10150 Highland Manor Dr
Suite 145
Tampa, FL 33610-9713

Phone

(813) 682-2401

Fax

(813) 682-2402

NPI assigned

Jun 29, 2007

Last updated

Jan 11, 2016By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1750588059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10150 HIGHLAND MANOR DR",
            "address_2": "SUITE 145",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336109713",
            "telephone_number": "813-682-2401",
            "fax_number": "813-682-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10150 HIGHLAND MANOR DR",
            "address_2": "SUITE 145",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336109713",
            "telephone_number": "813-682-2401",
            "fax_number": "813-682-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "TERRY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "DN11407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "DN11407",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Parker T Kelly, DPT
• Riawna Kelly, PHARMD
• Robin A Kelly, CNA
• Sean M. Kelly, D.O.
• Sophie Stirling Kelly, MD
• Shari Lynn Kelsay, LCSW
• Ashley A. Kelsey, PA
• Curran Kelsey
• Michael T Kelsey Jr., AAC
• Kathleen F Kemmer, CRNA

• Prosthodontics in Tampa, FL
• Providers in Tampa, FL by specialty
• Prosthodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; 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.