Michael Kelly, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

85769 Issued in GA

Practice address

1000 Cowles Clinc Way
Greensboro, GA 30642-5285

Phone

(706) 543-5858

NPI assigned

Oct 16, 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

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

85.62 of 100Reported as group

Quality

78.23

Promoting interoperability

100

Improvement activities

40

Cost

73.84

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Georgia Skin Cancer & Aestheitic Dermatology, LLC

  • Dermatology Physician
  • Watkinsville, GA
  • NPI 1205026168
  Medicare reassignment NPD

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1942380167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 RESURGENCE DR STE 100",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306777211",
            "telephone_number": "305-595-2969",
            "fax_number": "305-595-6491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 COWLES CLINC WAY",
            "city": "GREENSBORO",
            "state": "GA",
            "postal_code": "306425285",
            "telephone_number": "706-543-5858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8940 N Kendall Dr",
            "address_2": "Suite 903-E",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331762148",
            "country_code": "US",
            "telephone_number": "305-595-2969",
            "fax_number": "305-595-6491",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1180 Resurgence Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Watkinsville",
            "state": "GA",
            "postal_code": "306777211",
            "country_code": "US",
            "telephone_number": "706-543-5858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "58213",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "85769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J. Tyrone Jones, DDS
• Nicole Marie Juntz, DC
• Donna Amanda Kauffman, NP
• Emily Keeton, DMD
• Donald Matson Keiser III, RPH
• Kevin Adrian King, DPT
• Kingdom Medical Supply LLC
• Arun Kumar, M.D
• Karissa Joy Lacy, DC
• Lake Medical Center

• Plastic Surgery Physician in Greensboro, GA
• Providers in Greensboro, GA by specialty
• Plastic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.