Active NPI
James C Kelly, M.D.
- Family Medicine Physician
- Milledgeville, GA
National Provider Identifier
1760494082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 017841
- Practice address
- 620 Broad St
Central State Hospital
Milledgeville, GA 31062-7525 - Phone
- (478) 445-4128
- NPI assigned
- Aug 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 017841 | GA | Primary |
Addresses
Primary practice location
620 Broad St
Central State Hospital
Milledgeville, GA 31062-7525
Mailing address
620 Broad St
Central State Hospital
Milledgeville, GA 31062-7525
Phone (478) 445-4128
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017841 | GA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Georgia Heart Center, PC | Past | 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.
-
dba Central Georgia Heart Center
- Cardiovascular Disease Physician
- Macon, GA
- NPI 1780779363
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185840000000",
"number": "1760494082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 BROAD ST",
"address_2": "CENTRAL STATE HOSPITAL",
"city": "MILLEDGEVILLE",
"state": "GA",
"postal_code": "310627525",
"telephone_number": "478-445-4128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 BROAD ST",
"address_2": "CENTRAL STATE HOSPITAL",
"city": "MILLEDGEVILLE",
"state": "GA",
"postal_code": "310627525",
"telephone_number": "478-445-4128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "JAMES",
"middle_name": "C",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2007-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "017841",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milledgeville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.