Individual provider Active NPI

Robert William Kelly, M.D.

  • General Practice Physician
  • Metairie, LA
National Provider Identifier
1821098393
Registry record updated Mar 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
MD07659R Issued in LA
Practice address
671 Rosa Ave
Ste.101
Metairie, LA 70005-2843
Phone
(504) 833-2225
Fax
(504) 834-1391
NPI assigned
Jul 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X 07659R LA
General Practice Physician 208D00000X MD07659R LA Primary

Addresses

Primary practice location

671 Rosa Ave
Ste.101
Metairie, LA 70005-2843

Mailing address

2404 Edenborn Ave
Metairie, LA 70001-1817
Phone (504) 833-2225

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
07659RLAMDReproductive Endocrinology Physician
MD07659RLAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Rehab Nola Past Accepting new patients
American Back Institute of Greater New Orleans Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362441600000",
    "number": "1821098393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 EDENBORN AVE",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700011817",
            "telephone_number": "504-833-2225",
            "fax_number": "504-832-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "671 ROSA AVE",
            "address_2": "STE.101",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700052843",
            "telephone_number": "504-833-2225",
            "fax_number": "504-834-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ROBERT",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2013-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "LA",
            "license": "07659R",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "LA",
            "license": "MD07659R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; 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.