Organization Active NPI

Karen M. Kelly M.D.,P.a.

  • Pediatrics Physician
  • Wilmington, DE
National Provider Identifier
1972633345
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
C10004329 Issued in DE
Legal business name
KAREN M. KELLY M.D.,P.A.
Practice address
1941 Limestone Rd
Suite 206
Wilmington, DE 19808-5400
Phone
(302) 994-8887
Fax
(302) 994-8208
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Karen M Kelly, M.D.NPI 1679546444
Title
Owner
Phone
(302) 994-8887

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X C10004329 DE Primary

Addresses

Primary practice location

1941 Limestone Rd
Suite 206
Wilmington, DE 19808-5400

Mailing address

1941 Limestone Rd
Suite 206
Wilmington, DE 19808-5400
Phone (302) 994-8887

Other identifiers 1

IdentifierTypeStateIssuer
0000562301MedicaidDE

National Provider Directory

National Provider Directory

Locations

1941 Limestone Rd
Ste 206
Wilmington, DE 19808
Phone (302) 994-8887

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972633345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 LIMESTONE RD",
            "address_2": "SUITE 206",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198085400",
            "telephone_number": "302-994-8887",
            "fax_number": "302-994-8208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 LIMESTONE RD",
            "address_2": "SUITE 206",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198085400",
            "telephone_number": "302-994-8887",
            "fax_number": "302-994-8208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAREN M. KELLY M.D.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-994-8887",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "DE",
            "license": "C10004329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000562301",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.