Ted Martin Kelly, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101240536 Issued in VA

Practice address

100 15TH St NW
Norton, VA 24273-1616

Phone

(276) 679-9645

Fax

(276) 679-9762

NPI assigned

Sep 14, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902901952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 15TH ST NW",
            "address_2": "104",
            "city": "NORTON",
            "state": "VA",
            "postal_code": "242731620",
            "telephone_number": "276-679-8890",
            "fax_number": "276-679-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 15TH ST NW",
            "city": "NORTON",
            "state": "VA",
            "postal_code": "242731616",
            "telephone_number": "276-679-9645",
            "fax_number": "276-679-9762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "TED",
        "middle_name": "MARTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101240536",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G67501",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anilkumar Raghunath Joshi, MD
• Jacob D Justice, DMD
• Sanchita Suresh Kanakannavar, MD
• Jaimin Maheshbhai Kapadia, DO
• Gurvinder Kaur, MD
• Jeffrey McKinley Kennedy, LPC
• Jane Spera Hayes Kestner, APRN, CPNP-PC
• Aisha Khan
• Faizan Khan
• John Nhu Khuu, M.D.

• Internal Medicine Physician in Norton, VA
• Providers in Norton, VA by specialty
• Internal Medicine Physician in Virginia

• 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.