Tawaphan W Kelly, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

32776 Issued in TX

Practice address

4754 S 14TH St
Abilene, TX 79605-4733

Phone

(325) 480-1524

NPI assigned

Jul 13, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Centro de Salud Familiar la Fe, Inc

  • Federally Qualified Health Center (FQHC)
  • El Paso, TX
  • NPI 1629040621

  Dentist

  Medicare reassignment NPD
• Centro de Salud Familiar la Fe, Inc.

  • Federally Qualified Health Center (FQHC)
  • El Paso, TX
  • NPI 1669506952
  NPD

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1992189674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3773 PATRIOT DR APT 101",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796061843",
            "telephone_number": "402-670-8963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4754 S 14TH ST",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796054733",
            "telephone_number": "325-480-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "TAWAPHAN",
        "middle_name": "W",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-13",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "7214",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "32776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Keller
• Walt Kelley, M.D.
• Ashley Kelly
• Douglas Naismith Kelly
• Kendall Leigh Kelly
• David Barry Kemp, D.D.S.
• Megan Lee Kendall, RD LD
• Bradley Kendrick, M.D.
• Kenmar Residential Services, Incorporated
• Amber Marie Kennedy, LPC

• General Practice Dentistry in Abilene, TX
• Providers in Abilene, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.