J & S Kelly LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

J & S KELLY LLC

Practice address

4517 Avenue of the Cities
Moline, IL 61265-4551

Phone

(309) 762-1011

Fax

(309) 762-0094

NPI assigned

Jul 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. William M Kellenberger

Title

Owner

Phone

(563) 386-1553

Specialties & licenses 3

Addresses

Other names 1

• Kelly's Medical Equipment & Supply Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• J & S Kelly Galesburg L.L.C.

  • Oxygen Equipment & Supplies (DME)
  • Galesburg, IL
  • NPI 1942231287

  Member Of

  NPD member

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250121600000",
    "number": "1780609487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 E KIMBERLY RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071621",
            "telephone_number": "563-386-1553",
            "fax_number": "563-391-7702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4517 AVENUE OF THE CITIES",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612654551",
            "telephone_number": "309-762-1011",
            "fax_number": "309-762-0094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J & S KELLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2009-08-13",
        "status": "A",
        "authorized_official_last_name": "KELLENBERGER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-386-1553",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "IL",
            "license": "203.000827",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kelly's Medical Equipment & Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Harvey P Jack, D.C.
• Benjamin Joseph Jackson, DMD
• Joseph Daniel Jackson, D.M.D.
• Adam Jacobsen, D.C.

• Oxygen Equipment & Supplies (DME) in Moline, IL
• Providers in Moline, IL by specialty
• Oxygen Equipment & Supplies (DME) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2009; 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.