Brett Lee Kelley

Individual provider Active NPI Paramedic · Moulton, AL

NPI 1972259174 · NPPES record last updated Feb 25, 2022

Key facts

NPI
1972259174
Entity type
Individual (NPI type 1)
Primary specialty
Paramedic 146L00000X
License
0500943 (AL)
Practice address
13414 Al Highway 157 Ste B
Moulton, AL 35650-3704
Phone
(256) 341-7676
Fax
(855) 326-1353
NPI assigned
Feb 25, 2022
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
0500943ALMDParamedic

Practice roles

OrganizationSpecialtyStatusNew patients
Alabama Specialty Care Transport LLC Current
since Mar 30, 2022
Accepting new patients

Locations

13414 AL Highway 157
Ste B
Moulton, AL 35650
Phone (256) 341-7676

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Paramedic 146L00000X 0500943 AL Yes

Addresses

Primary practice location

13414 Al Highway 157 Ste B
Moulton, AL 35650-3704

Mailing address

PO Box 772
Moulton, AL 35650-0772
Phone (256) 341-7676

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL alabamaspecialtycaretransport@gmail.com Health Information Exchange (HIE)

Other providers in Moulton, AL

All providers in Moulton, AL · Paramedic in Alabama

Sources for this page

Verify at the official NPI Registry.