The Kelly Code, LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

THE KELLY CODE, LLC

Practice address

3219 Landmark St Ste B
Greenville, NC 27834-7688

Phone

(252) 412-1963

NPI assigned

Nov 19, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Kim J Kelly, LCASNPI 1730457193

Title

Owner

Phone

(252) 412-1963

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Kelly Code Doing business as

Locations

Practitioners 1

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

• Kim J Kelly, LCAS

  • Addiction (Substance Use Disorder) Counselor
  • Selma, NC
  • NPI 1730457193
  NPD (past) Authorized official

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

{
    "created_epoch": "1542585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542585600000",
    "number": "1922577022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 WESTWOOD DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345015",
            "telephone_number": "252-412-1963",
            "fax_number": "252-364-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3219 LANDMARK ST STE B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347688",
            "telephone_number": "252-412-1963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE KELLY CODE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-19",
        "last_updated": "2018-11-19",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-412-1963",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCAS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730457193",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Kelly Code",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Addiction (Substance Use Disorder) Counselor in Greenville, NC
• Providers in Greenville, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; 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.