Sonja B. Kelleher, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

072047 Issued in GA

Practice address

6401 Shallowford Rd
Chattanooga, TN 37421-5406

Phone

(352) 359-6129

NPI assigned

May 12, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sonja Grace Louise Boulware Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1861784555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 CLASSIC TRL",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307366010",
            "telephone_number": "352-359-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 SHALLOWFORD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374215406",
            "telephone_number": "352-359-6129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEHER",
        "first_name": "SONJA",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-12",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "072047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAINING LICENSE",
            "identifier": "16874",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SONJA",
            "last_name": "BOULWARE",
            "middle_name": "GRACE LOUISE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Keith
• Callie Kell, M.A., NCC
• Carol Kell, LPN
• Wanda Kell, LPN
• Pamela Jean Kelle, RDN, CEDRD, LD
• Bradley S. Keller, CRNA
• Angela Denise Kitchens Kelley, RN, MSN, GNP-BC
• Elisabeth Kelley, ATC
• Mary Beth Kelley
• Oscar T Kelley, CRNA

• Family Medicine Physician in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.