Mark Damien Kelley, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

9072 Issued in RI

Practice address

1130 Ten Rod Rd
The Meadows Building D, Ste 103
North Kingstown, RI 02852-4179

Phone

(401) 295-4409

Fax

(401) 295-1209

NPI assigned

May 12, 2006

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

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204675200000",
    "number": "1952351447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 TEN ROD RD",
            "address_2": "STE D103",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028524179",
            "telephone_number": "401-295-4409",
            "fax_number": "401-295-1209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 TEN ROD RD",
            "address_2": "THE MEADOWS BUILDING D, STE 103",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028524179",
            "telephone_number": "401-295-4409",
            "fax_number": "401-295-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "MARK",
        "middle_name": "DAMIEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2008-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "9072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariam Kanteh, PA-C
• Andrew Karp, PSYD
• Kathleen Treloar Licsw LLC
• Kelley Gemma, LLC
• Kelley Gemma, LLC Dba Ocean State Psychotherapy, Inc.
• Karlene A Kelly, SLP
• Susan C Kelly, D.O.
• Prachi Kene, PHD, ABPP
• George Anthony Kenna, PHD, RPH
• Linda Kenyon

• Internal Medicine Physician in North Kingstown, RI
• Providers in North Kingstown, RI by specialty
• Internal Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.