Individual provider Active NPI

Douglas Naismith Kelly

  • Certified Registered Nurse Anesthetist
  • Abilene, TX
National Provider Identifier
1831610450
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP135094 Issued in TX
Practice address
1900 Pine St
Abilene, TX 79601-2432
Phone
(325) 670-4220
Fax
(325) 670-4040
NPI assigned
Jul 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP135094 TX Primary
Certified Registered Nurse Anesthetist 367500000X 925507 TX

Addresses

Primary practice location

1900 Pine St
Abilene, TX 79601-2432

Mailing address

PO Box 1198
Abilene, TX 79604-1198
Phone (325) 670-4372

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191007000848 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 3274808175 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1400 S Dobson Rd
Mesa, AZ 85202-4707
Phone (480) 412-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP135094TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Partners of Arizona LLC CurrentSince Aug 1, 2019 Accepting new patients
Anesthesia Partners & Management LLC Nurse Anesthetist, Certified Registered CurrentSince May 23, 2020 Accepting new patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Metro Anesthesia Consultants P C Past Accepting new patients

Locations

1020 N San Francisco St
Ste 100
Flagstaff, AZ 86001
Phone (928) 774-2300

3420 S Mercy Rd
Ste 200
Gilbert, AZ 85297
Phone (480) 909-3788

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

7301 N 16th St
Ste 102
Phoenix, AZ 85020
Phone (602) 772-8600

7330 N 16th St
Ste A200
Phoenix, AZ 85020
Phone (602) 200-9021

3900 E Camelback Rd
Ste 190
Phoenix, AZ 85018
Phone (888) 724-6236

4605 E Elwood St
Ste 500
Phoenix, AZ 85040
Phone (469) 998-7443

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

3110 Clearwater Dr
Prescott, AZ 86305
Phone (623) 241-6185

8952 E Desert Cove Ave
Ste 113
Scottsdale, AZ 85260
Phone (480) 314-7772

10494 W Thunderbird Blvd
Ste 102
Sun City, AZ 85351
Phone (623) 975-8311

10503 W Thunderbird Blvd
Ste 317
Sun City, AZ 85351
Phone (623) 546-1400

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

14502 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 214-4000

2000 E Southern Ave
Ste 102
Tempe, AZ 85282
Phone (480) 820-9141

1704 W Anklam Rd
Ste 108
Tucson, AZ 85745
Phone (623) 241-6185

2100 Lakeside Blvd
Ste 250
Richardson, TX 75082
Phone (469) 998-7443

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1831610450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1198",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796041198",
            "telephone_number": "325-670-4372",
            "fax_number": "325-670-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 PINE ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012432",
            "telephone_number": "325-670-4220",
            "fax_number": "325-670-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "DOUGLAS",
        "middle_name": "NAISMITH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP135094",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "925507",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.