Patrick L Kelley, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1207 Issued in AZ

Practice address

150 S 12TH St
Phoenix, AZ 85034-2301

Phone

(602) 495-5797

NPI assigned

Jun 8, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• City of Phoenix Arizona

  • Paramedic
  • Phoenix, AZ
  • NPI 1982781571
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902846504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S 12TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850342301",
            "telephone_number": "602-495-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S 12TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850342301",
            "telephone_number": "602-495-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "PATRICK",
        "middle_name": "L",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "1207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Kelley, DO
• Kelly Young Kelley, MSW
• Kimberly Kelley, PHARM.D.
• Lee Ann Kelley, M.D.
• Lonna Beth Kelley, AGNP
• Paul J Kelley, MD
• Suzanne Kelley, NP
• Joshua G Kellison, PHD
• Nicole Renee Kellum, N.D.
• Rodney Jamal Kellum, CRNA

• Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.