Grant Gordon Kelley, M.D.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

205703 Issued in NY

Practice address

301 Prospect Ave
Hospital Internists
Syracuse, NY 13203-1807

Phone

(315) 448-5704

Fax

(315) 423-6853

NPI assigned

Oct 9, 2008

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278892800000",
    "number": "1922259845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "address_2": "HOSPITAL INTERNISTS",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-448-5704",
            "fax_number": "315-423-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "address_2": "HOSPITAL INTERNISTS",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-448-5704",
            "fax_number": "315-423-6853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "GRANT",
        "middle_name": "GORDON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-09",
        "last_updated": "2010-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "205703",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "205703",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01724529",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabrielle A Kekedakis, CASAC-T
• Alicia Ann Kell, MSN, FNP-BC
• Jessica A Keller, MS
• Scott Kellett, DO
• Ashley Paseman Kelley, MA CCC SLP
• Renee Kelley
• Richard Thomas Kelley, M.D.
• Shannon Kathleen Kelley, PMHNP, LCSW, CASAC
• Shari L Kelley, NP
• Dennis William Kellington, MA, ATC

• Hospitalist Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Hospitalist Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; 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.