Kelly Ahmed M.D., Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A51407 Issued in CA

Legal business name

KELLY AHMED M.D., INC.

Practice address

14285 Amargosa Rd
Victorville, CA 92392-9707

Phone

(760) 955-7095

Fax

(760) 951-1076

NPI assigned

Oct 16, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Kelly J Ahmed, M.D.NPI 1659303998

Title

Owner

Phone

(760) 955-7095

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Kelly Ahmed MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kelly Ahmed M.D., Inc.

  • Primary Care Clinic/Center
  • Victorville, CA
  • NPI 1427484658
  NPD tax ID

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly Ahmed, MD

  • Family Medicine Physician
  • Victorville, CA
  • NPI 1659303998
  Medicare reassignment Care Compare group NPD Authorized official
• Tonya Maria Pinkerton, PA-C

  • Physician Assistant
  • Victorville, CA
  • NPI 1952538779
  Medicare reassignment Care Compare group NPD
• Omer Ahmed, MD

  • Cardiovascular Disease Physician
  • Victorville, CA
  • NPI 1962429431
  NPD

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

{
    "created_epoch": "1444953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444953600000",
    "number": "1902277940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14285 AMARGOSA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923929707",
            "telephone_number": "760-955-7095",
            "fax_number": "760-951-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14285 AMARGOSA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923929707",
            "telephone_number": "760-955-7095",
            "fax_number": "760-951-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY AHMED M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-16",
        "last_updated": "2015-10-16",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-955-7095",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A51407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICEANSE",
            "identifier": "A51407",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Xuan Ke
• Catherine Keating Keating
• Keith Mark Gross MD Inc
• Paige Kelley
• Kelly Ahmed M.D., Inc.
• Kelly E. Hong, DDS, Inc. (Kelly Smile Dentistry)
• Stan Kemp
• Kendracare Medical Group, Inc. (Kare Medical Group, Inc.)
• Aelita Kennedy, M.D.
• Kenneth Percy Peterson, MD, Inc.

• Family Medicine Physician in Victorville, CA
• Providers in Victorville, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.