Patrick Mark Kelley, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

ME32802 Issued in FL

Practice address

15 Doctors Dr
Panama City, FL 32405-4520

Phone

(850) 769-8991

Fax

(850) 769-3708

NPI assigned

Sep 25, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Panama City Neurosurgery PA

  • Neurological Surgery Physician
  • Panama City, FL
  • NPI 1437601648
  NPD

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432598400000",
    "number": "1861593949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 DOCTORS DR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054520",
            "telephone_number": "850-769-8991",
            "fax_number": "850-769-3708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 DOCTORS DR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054520",
            "telephone_number": "850-769-8991",
            "fax_number": "850-769-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "PATRICK",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2015-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME32802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031772-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelley Keller Clark, AG-ACNP
• Elizabeth Keller
• Joe Mac Keller, DDS MS
• Brandi Nichole Kelley
• Justin Patrick Kelley, CRNA
• Timothy Buddy Kelley, RPH
• Adel Marie Kelly, NP
• Charlie N Kelly, ARNP-BC
• Jerry B Kelly, R.PH.
• Kareem Kelly

• Plastic Surgery Physician in Panama City, FL
• Providers in Panama City, FL by specialty
• Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.