Norman Ray Kelley, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

20323 Issued in NE

Practice address

11330 Q St
Omaha, NE 68137-3679

Phone

(402) 660-1549

Fax

(402) 504-3496

NPI assigned

Jul 19, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Physician Homecare Associates

  • Geriatric Medicine (Family Medicine) Physician
  • Valley, NE
  • NPI 1942228820
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1821017625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11330 Q ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681373679",
            "telephone_number": "402-660-1549",
            "fax_number": "402-504-3496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11330 Q ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681373679",
            "telephone_number": "402-660-1549",
            "fax_number": "402-504-3496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "NORMAN",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NE",
            "license": "20323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MR CODE",
            "identifier": "268399",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD#ALTID 4",
            "identifier": "47073897408",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Kelley
• Jametria Marie Kelley
• Kelsey Linn Kelley, APRN
• Michael R. Kelley, PH.D.
• Nila Kelley
• Samantha Kelley
• Shawn Kelley
• Kellie Berry-Hert Aprn LLC
• Adrian Larhon Kellogg II
• Akia Lynne Kellogg

• Pediatric Adolescent Medicine Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Pediatric Adolescent Medicine Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.