Diane J Kelly, MD

Primary specialty

Obstetrics PhysicianTaxonomy code 207VX0000X

License

ME47018 Issued in FL

Practice address

1223 Gateway Dr
Melbourne, FL 32901-2607

Phone

(321) 729-6166

Fax

(321) 952-9406

NPI assigned

Nov 2, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Diane Kelly Morrill Former name

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270771200000",
    "number": "1932190600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 GATEWAY DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012607",
            "telephone_number": "321-729-6166",
            "fax_number": "321-952-9406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 GATEWAY DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012607",
            "telephone_number": "321-729-6166",
            "fax_number": "321-952-9406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "DIANE",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2010-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "FL",
            "license": "ME47018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "160045705",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042339400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "MORRILL",
            "middle_name": "KELLY",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cori Devon Kellner, ARNP, WHNP-BC
• Krista Janine Delaney Kello, AU.D.
• Kelly L Dunn MD PA
• Kerilynn Kelly-Moss
• Amber Kelly
• Emily Fell Kelly, MD
• Helena Kelly
• Patricia Marie Arenella Kelly, DNP, APRN, FNP-BC
• Lisa A Kemmler
• Kemp Medical Center P a

• Obstetrics Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Obstetrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.