Eric Scott Kelley, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6668 Issued in KY

Practice address

1332 Andrea St
Bowling Green, KY 42104-3334

Phone

(270) 843-9950

Fax

(270) 873-4063

NPI assigned

Mar 30, 2007

Last updated

Dec 6, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1942320387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1332 ANDREA ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043334",
            "telephone_number": "270-843-9950",
            "fax_number": "270-873-4063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1332 ANDREA ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043334",
            "telephone_number": "270-843-9950",
            "fax_number": "270-873-4063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "ERIC",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "6668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristy M Keeney, APRN
• Tiffany Dianne Keeney, MS CCC-SLP
• Keep Your Footing LLC
• Latonya Kees
• Gerald Keith
• Natalie Christine Kelley
• Taylor Payne Kelley, CRNA
• William Eric Kelley, FNP
• Amber Kelly
• Kathleen Kelly

• General Practice Dentistry in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.