Organization Active NPI

Kelley Sports and Wellness, PLLC

  • Chiropractor
  • Deer Park, TX
National Provider Identifier
1962119354
Registry record updated Apr 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
KELLEY SPORTS AND WELLNESS, PLLC
Practice address
3710 Center St Unit 101
Deer Park, TX 77536-6104
Phone
(346) 701-5791
NPI assigned
Nov 3, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2023

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

Authorized official

Name
Whitley Kelley, D.C.
Title
Provider
Phone
(361) 404-1252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

3710 Center St Unit 101
Deer Park, TX 77536-6104

Mailing address

1421 Garden Park Dr
Deer Park, TX 77536-3668
Phone (361) 404-1252

National Provider Directory

National Provider Directory

Locations

3710 Center St
#101
Deer Park, TX 77536
Phone (346) 701-5791

10910 Spencer Hwy
Ste A
La Porte, TX 77571
Phone (281) 760-3597

NPI Registry JSON

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

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682208000000",
    "number": "1962119354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 GARDEN PARK DR",
            "city": "DEER PARK",
            "state": "TX",
            "postal_code": "775363668",
            "telephone_number": "361-404-1252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 CENTER ST UNIT 101",
            "city": "DEER PARK",
            "state": "TX",
            "postal_code": "775366104",
            "telephone_number": "346-701-5791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLEY SPORTS AND WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-03",
        "last_updated": "2023-04-23",
        "certification_date": "2023-04-23",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "WHITLEY",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "361-404-1252",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2023; 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.