Active NPI
Michael Fredrick Kelley, M.D.
- Public Health & General Preventive Medicine Physician
- Huntsville, TX
National Provider Identifier
1790763704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- G6189
- Practice address
- 3009A Highway 30 W
Huntsville, TX 77340-3517 - Phone
- (936) 437-3570
- NPI assigned
- Jan 9, 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 |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | G6189 | TX | Primary |
Addresses
Primary practice location
3009A Highway 30 W
Huntsville, TX 77340-3517
Mailing address
3009A Highway 30 W
Huntsville, TX 77340-3517
Phone (512) 268-0114
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G6189 | TX | MD | Public Health & General Preventive Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1790763704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3009A HIGHWAY 30 W",
"city": "HUNTSVILLE",
"state": "TX",
"postal_code": "773403517",
"telephone_number": "512-268-0114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3009A HIGHWAY 30 W",
"city": "HUNTSVILLE",
"state": "TX",
"postal_code": "773403517",
"telephone_number": "936-437-3570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "MICHAEL",
"middle_name": "FREDRICK",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-09",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "TX",
"license": "G6189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntsville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.