Active NPI
Matthew Kelly, BC-HIS
- Hearing Instrument Specialist
- Clarksville, TN
National Provider Identifier
1891225801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 752
- Practice address
- 1754 Madison St Ste a
Clarksville, TN 37043-2923 - Phone
- (931) 645-4467
- NPI assigned
- Jun 13, 2017
- 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 |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 752 | TN | Primary |
Addresses
Primary practice location
1754 Madison St Ste a
Clarksville, TN 37043-2923
Mailing address
1754 Madison St Ste a
Clarksville, TN 37043-2923
Phone (931) 645-4467
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497312000000",
"number": "1891225801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1754 MADISON ST STE A",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370432923",
"telephone_number": "931-645-4467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1754 MADISON ST STE A",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370432923",
"telephone_number": "931-645-4467"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "MATTHEW",
"name_prefix": "Mr.",
"credential": "BC-HIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-13",
"last_updated": "2017-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "TN",
"license": "752",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.