James Patrick Thomas Kelley, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

22319 Issued in SC

Practice address

1200 E Main St Ste 12
Spartanburg, SC 29307-1738

Phone

(864) 560-9260

Fax

(864) 560-9265

NPI assigned

Feb 6, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkelley7828@direct-srhs.et0939.epichosted.com

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.

• Spartanburg Medical Center

  dba Medical Group of the Carolinas - Spineand Pain Management - NorthGrove

  • Neuromusculoskeletal Medicine & OMM Physician
  • Spartanburg, SC
  • NPI 1043309917
  Medicare reassignment NPD
• Spartanburg Medical Center

  dba Medical Group of the Carolinas - Family Medicine - Boiling Springs

  • Family Medicine Physician
  • Boiling Springs, SC
  • NPI 1235170077
  Medicare reassignment NPD
• Carolina Health DPC

  • Family Nurse Practitioner
  • Duncan, SC
  • NPI 1023797636
  NPD
• Spartanburg Medical Center

  dba Medical Group of the Carolinas - Immediate Care Center - Westside

  • Urgent Care Clinic/Center
  • Spartanburg, SC
  • NPI 1508819483
  NPD
• Spartanburg Medical Center

  dba Medical Group of the Carolinas - Immediate Care Center-Gaffney

  • Family Medicine Physician
  • Gaffney, SC
  • NPI 1770943342
  NPD
• Spartanburg Medical Center

  dba Medical Group of the Carolinas Pain Management Wood Street

  • Physical Medicine & Rehabilitation Physician
  • Spartanburg, SC
  • NPI 1942188875
  NPD

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1902361611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E MAIN ST STE 12",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071738",
            "telephone_number": "864-560-9260",
            "fax_number": "864-560-9265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "JAMES",
        "middle_name": "PATRICK THOMAS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-06",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "22319",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "22319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCE6826067",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP5742",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCE6826084",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCE682J577",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCE6826121",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkelley7828@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jkelley7828@direct-srhs.et0939.epichosted.com",
            "address_1": "1200 E Main St Ste 12",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293071738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Valerie Keller
• Natalie Nicole Kellett
• Amanda Kelley, CRNA
• Ana Kelley, LPC
• Brittany Pridemore Kelley
• Jason Kelly, MD
• Katherine Kelly
• Phyllis H Kelly
• Shatearia Kelly
• Bianca Marie Kelsey, RN, BSN

• Family Nurse Practitioner in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.