Kellam & Associates

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

KELLAM & ASSOCIATES

Practice address

399 S Broadway St
Lake Orion, MI 48362-2740

Phone

(248) 338-5604

Fax

(248) 338-5605

NPI assigned

Jul 15, 2008

Reactivated

Oct 28, 2009

Last updated

Dec 14, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leighton Lum, D.O.

Title

Partner

Phone

(734) 677-7400

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Herbert R. Kaufman, D.O.

  • Diagnostic Radiology Physician
  • Lake Orion, MI
  • NPI 1649200437
  NPD (past)

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260748800000",
    "number": "1811151202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 VARSITY DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481082233",
            "telephone_number": "734-677-7400",
            "fax_number": "734-677-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 S BROADWAY ST",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483622740",
            "telephone_number": "248-338-5604",
            "fax_number": "248-338-5605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLAM & ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-15",
        "last_updated": "2009-12-14",
        "deactivation_date": "2009-01-22",
        "reactivation_date": "2009-10-28",
        "status": "A",
        "authorized_official_last_name": "LUM",
        "authorized_official_first_name": "LEIGHTON",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "734-677-7400",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amita Kanyal
• Daniel Stephen Kasprick, M.D.
• Kevin Kathawa, DDS
• Herbert R. Kaufman, D.O.
• Brad David Kegebein
• Cathleen M Kelly, MA, LLPC
• Sarah Kelsey, BSN, RN, IBCLC
• Sarah Noelle Kerr
• Madison Mae Kett
• Adam Kettlewell

• Pain Medicine Physician in Lake Orion, MI
• Providers in Lake Orion, MI by specialty
• Pain Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.