Peter J Kelsall, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G0446 Issued in TX

Practice address

612 N Story Rd Ste 107
Irving, TX 75061-6764

Phone

(972) 986-6885

NPI assigned

Dec 13, 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 names 1

• Peter J Kelsall Professional 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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871654574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 N STORY RD STE 107",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750616764",
            "telephone_number": "972-986-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 N STORY RD STE 107",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750616764",
            "telephone_number": "972-986-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSALL",
        "first_name": "PETER",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G0446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PETER",
            "last_name": "KELSALL",
            "middle_name": "J",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Keith D Snitker DDS PA
• Antonya Kelley, DC
• Amanda Kelly, CRNA
• Breanna Lynn Kelly, M.S. CF-SLP
• Christy Ann Kelly
• Kelsom Clinic PA
• Chloe Kemp
• Amanda Paige Kendig, LCSW
• Kasi Lee Kendl, D.P.T.
• Haman Cedric Kengne Wankam, PHARM D

• Family Medicine Physician in Irving, TX
• Providers in Irving, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.