Kevin Gerard Kelly

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

KEVIN GERARD KELLY

Practice address

13150 Highway 43
Suite 10
Russellville, AL 35653-4558

Phone

(256) 332-5901

Fax

(256) 332-6911

NPI assigned

Feb 7, 2013

Organization subpart

No

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

Authorized official

Name

Kevin Gerard Kelly, M.D.

Title

Owner

Phone

(256) 332-5901

Specialties & licenses 1

Addresses

Other names 1

• Kevin G. Kelly, MD Doing business as

Locations

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"
        }
    ]
}

• Katherine Marie Johnson, LPTA
• Daphne Lynn Jones, MD
• Barbara A Keenum, PT
• Kevin Gerard Kelly
• Kevin G. Kelly, M.D.
• Jody Kiel, PHARMD
• Haley Shaleigh Knight
• Harry Willi Kuberg, M.D.
• Laboratory Corporation of America Holding
• Lakeshore Pediatrics of Russellville

• Rural Health Clinic/Center in Russellville, AL
• Providers in Russellville, AL by specialty
• Rural Health Clinic/Center in Alabama

• 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.