Marise Kelly, M.D., P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

J9727 Issued in TX

Legal business name

MARISE KELLY, M.D., P.A.

Practice address

900 Broadway St
Houston, TX 77012-2127

Phone

(713) 928-2774

Fax

(713) 928-2781

NPI assigned

Oct 5, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Marise Kelly, M.D.NPI 1124056304

Title

Director

Phone

(713) 928-2774

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

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

• Marise Kelly, M.D.

  • Family Medicine Physician
  • Houston, TX
  • NPI 1124056304
  Medicare reassignment Authorized official
• Nsuela Rosy Mukana, M.D.

  • Family Medicine Physician
  • Houston, TX
  • NPI 1427284017
  Medicare reassignment

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

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306454400000",
    "number": "1790010064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 BROADWAY ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770122127",
            "telephone_number": "713-928-2774",
            "fax_number": "713-928-2781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 BROADWAY ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770122127",
            "telephone_number": "713-928-2774",
            "fax_number": "713-928-2781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARISE KELLY, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-05",
        "last_updated": "2011-05-27",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "MARISE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "713-928-2774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J9727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219659401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219659402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marion J. Danna, D.C., P. a.
• Donald Marion
• Jelencia Jenae Marion, NP
• Jessica Renee Maris, CRNA
• Mary Mariscalco, MD
• Maritime Pharmacy
• Maritza Martinez-Chinchilla and Associates
• Marjaneh a. Azad, DDS PA
• Mark a Jacobs MD PA
• Mark a. Schusterman, M.D., P.a.

• Family Medicine Physician in Houston, TX
• Providers in Houston, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.