NPIMap

Organization Active NPI

Kevin Gerard Kelly

Doing business as Kevin G. Kelly, MD

  • Rural Health Clinic/Center
  • Russellville, AL
National Provider Identifier
1902145188
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
KEVIN GERARD KELLY
Doing business as
Kevin G. Kelly, MD
Practice address
13150 Highway 43
Suite 10
Russellville, AL 35653-4558
Phone
(256) 332-5901
Fax
(256) 332-6911
NPI assigned
Feb 7, 2013
Last updated
Jan 18, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Authorized official

Name
Kevin Gerard Kelly, M.D.NPI 1710972385
Title
Owner
Phone
(256) 332-5901

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

13150 Highway 43
Suite 10
Russellville, AL 35653-4558

Mailing address

13150 Highway 43
Suite 10
Russellville, AL 35653-4558
Phone (256) 332-5901

Other names 1

  • Kevin G. Kelly, MD Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1360195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1902145188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13150 HIGHWAY 43",
            "address_2": "SUITE 10",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "356534558",
            "telephone_number": "256-332-5901",
            "fax_number": "256-332-6911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13150 HIGHWAY 43",
            "address_2": "SUITE 10",
            "city": "RUSSELLVILLE",
            "state": "AL",
            "postal_code": "356534558",
            "telephone_number": "256-332-5901",
            "fax_number": "256-332-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN GERARD KELLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-07",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "GERARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-332-5901",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kevin G. Kelly, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Russellville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.

Verify at the official NPI Registry.