Robert M Kelleher, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

012223 Issued in GA

Practice address

875 Johnson Ferry Rd
Suite 300
Atlanta, GA 30342

Phone

(404) 257-9933

Fax

(404) 257-9931

NPI assigned

Aug 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

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.

• Metroderm, P.C.

  • MOHS-Micrographic Surgery Physician
  • Atlanta, GA
  • NPI 1205833894
  Medicare reassignment NPD
• Metroderm, P.C.

  • Specialist
  • Gainesville, GA
  • NPI 1942929062
  NPD
• Wesley S Wilborn MD PC

  • Dermatology Physician
  • Atlanta, GA
  • NPI 1750554978
  NPD (past)

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1891787172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 JOHNSON FERRY RD",
            "address_2": "SUITE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "404-257-9933",
            "fax_number": "404-257-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 JOHNSON FERRY RD",
            "address_2": "SUITE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "404-257-9933",
            "fax_number": "404-257-9931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEHER",
        "first_name": "ROBERT",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "012223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betty A Kelahan, LPC
• Karia Bryn Kelch-Oliver, PH.D.
• William J Keldahl, PA
• Katlyn Kelleher
• Meredith Page Kelleher, M.M.SC., PA-C
• Chelsea Keller, M.A., BCBA
• Curtis Michael Keller, MD
• Frank Keller Jr., MD
• Gina Keller, NP
• James Keller

• Specialist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.