NPIMap

Organization Active NPI

Kelly Clinic

  • Internal Medicine Physician
  • Richmond, TX
National Provider Identifier
1780164426
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P3014 Issued in TX
Legal business name
KELLY CLINIC
Practice address
5503 FM 359 Rd Ste C
Richmond, TX 77406-7835
Phone
(281) 828-0675
Fax
(281) 605-6863
NPI assigned
Aug 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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

Authorized official

Name
Dr. John M Kelly, MDNPI 1437146370
Title
Physician
Phone
(505) 803-6837

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X P3014 TX Primary

Addresses

Primary practice location

5503 FM 359 Rd Ste C
Richmond, TX 77406-7835

Mailing address

5503 FM 359 Rd Ste C
Richmond, TX 77406-7835
Phone (505) 803-6837

National Provider Directory

National Provider Directory

Locations

5503 FM 359 Rd
Ste C
Richmond, TX 77406
Phone (281) 241-7022

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534809600000",
    "number": "1780164426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5503 FM 359 RD STE C",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774067835",
            "telephone_number": "505-803-6837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5503 FM 359 RD STE C",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774067835",
            "telephone_number": "281-828-0675",
            "fax_number": "281-605-6863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "505-803-6837",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P3014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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.