Dr John Kelly Anesthesia PC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

DR JOHN KELLY ANESTHESIA PC

Practice address

17 Knollwood Rd
Glen Head, NY 11545-3318

Phone

(516) 578-3028

NPI assigned

May 24, 2023

Last updated

May 24, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Kelly, DO

Title

President

Phone

(516) 578-3028

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1972295293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 KNOLLWOOD RD",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115453318",
            "telephone_number": "516-578-3028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 KNOLLWOOD RD",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115453318",
            "telephone_number": "516-578-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JOHN KELLY ANESTHESIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-578-3028",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Glen Head, NY
• Providers in Glen Head, NY by specialty
• Anesthesiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.