Kevin F Kelley Sr., PA-C
Individual provider Active NPI Medical Physician Assistant · Indian Head, MD
NPI 1881654697 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1881654697
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 0110840675 (VA)
- Practice address
- 101 Strauss Ave
Cbirf, 2ND Mef
Indian Head, MD 20640-1542 - Phone
- (301) 744-1004
- Fax
- (301) 744-1028
- NPI assigned
- Mar 24, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0110840675 | VA | MD | Medical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 0110840675 | VA | Yes |
Addresses
Primary practice location
101 Strauss Ave
Cbirf, 2ND Mef
Indian Head, MD 20640-1542
Mailing address
111 Strauss Ave
Indian Head, MD 20640-1524
Phone (301) 744-1004
Other providers in Indian Head, MD
- Surnita Lawon Jefferson-Jones
- Sherry Teresa Johnson
- Carllisa Roshea Jordan
- Memuna Kamara
- Grace W Kariuki
- Keyana Kelly
- Latortue Smiles
- Michelle Latortue
- Alan I Lemberg
- Holly N Leymeister
All providers in Indian Head, MD · Medical Physician Assistant in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.