Thomas John Kelly, DC, DIBCN

Primary specialty

Neurology ChiropractorTaxonomy code 111NN0400X

License

CH00003084 Issued in WA

Practice address

6700 NE 162ND Ave
Suite 415
Vancouver, WA 98682-3858

Phone

(360) 882-0767

Fax

(360) 885-2580

NPI assigned

Mar 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kelly Chiropractic, PS

  • Neurology Chiropractor
  • Vancouver, WA
  • NPI 1821396078
  NPD (past) Authorized official

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1811013311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 NE 162ND AVE",
            "address_2": "SUITE 415",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986823858",
            "telephone_number": "360-882-0767",
            "fax_number": "360-885-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 NE 162ND AVE",
            "address_2": "SUITE 415",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986823858",
            "telephone_number": "360-882-0767",
            "fax_number": "360-885-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC, DIBCN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "WA",
            "license": "CH00003084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Kelly
• Natalie Jade Kelly
• Nicole C Kelly, MD
• Rose Kelly, LICSW
• Tammy Jean Kelly, WA60557072
• Valerie Carla Kelly, LMP
• Virginia Sohn Kelly, M.D.
• Susan Louise Kelsay, LMFTA
• Brad Kelso, DC
• Lyle Duane Kelstrom, DDS

• Neurology Chiropractor in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Neurology Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.