Active NPI
John Duane Kelly III, DC
- Chiropractor
- Mesa, AZ
National Provider Identifier
1841804176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 8900
- Practice address
- 1728 S Greenfield Rd Ste 109
Mesa, AZ 85206-3484 - Phone
- (480) 435-1843
- NPI assigned
- Sep 3, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 8900 | AZ | Primary |
Addresses
Primary practice location
1728 S Greenfield Rd Ste 109
Mesa, AZ 85206-3484
Mailing address
1728 S Greenfield Rd Ste 109
Mesa, AZ 85206-3484
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8900 | AZ | MD | Child Mental Illness Respite Care |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hopeful Chiropractic LLC | Chiropractor | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Mesa, AZ
- NPI 1396359626
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599091200000",
"number": "1841804176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1728 S GREENFIELD RD STE 109",
"city": "MESA",
"state": "AZ",
"postal_code": "852063484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1728 S GREENFIELD RD STE 109",
"city": "MESA",
"state": "AZ",
"postal_code": "852063484",
"telephone_number": "480-435-1843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "JOHN",
"middle_name": "DUANE",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-03",
"last_updated": "2020-09-03",
"certification_date": "2020-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AZ",
"license": "8900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.