DR. BRIAN J. KELLY (NPI# 1275550717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275550717 |
| Entity Type | Individual |
| Full Name | DR. BRIAN J. KELLY |
| Credential | M.D. |
| Practice Address |
11365 Dorsett Rd. Maryland Heights MO 63043 |
| Practice Telephone | 3148726430 |
| Practice Fax Number | 3148726500 |
| Mailing Telephone | 3148726430 |
| Mailing Fax Number | 3148726500 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2009-03-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 105182 | MO | Allopathic & Osteopathic Physicians |
| N | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
105182 | MO | Allopathic & Osteopathic Physicians |
| N | 2080P0204X |
Pediatrics Specialization: Pediatric Emergency Medicine |
105182 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 207674029 | 05 | |
| IL | 036057823 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649763368 | Brian Kelly | Dentist | 9134 Middlebelt Rd, Livonia, MI 48150-4035 | 2018-06-07 |
| 1801330436 | Brian Kelly | Social Worker | 240 Kensington Ln, Austin, TX 78737-4505 | 2016-12-16 |
| 1588093207 | Brian Kelly | Physical Therapist | 2801 Quebec St Nw Apt 548, Washington, DC 20008-6249 | 2013-11-04 |
| 1871810754 | Brian John Kelly | Psychiatry & Neurology | 47547 Coldspring Pl, Sterling, VA 20165-7446 | 2010-04-30 |
| 1073695953 | Brian M Kelly | Physical Medicine & Rehabilitation | 2850 S Industrial Hwy Ste 400, Ann Arbor, MI 48104-6796 | 2006-10-19 |
| 1396857892 | Brian G Kelly | Obstetrics & Gynecology | 25959 Kelly Road, Suite B, Roseville, MI 48066 | 2006-08-31 |
| 1376653451 | Brian Michael Kelly | Physical Therapist | 8228 Brentwood Industrial Dr, Saint Louis, MO 63144-2815 | 2006-08-30 |
| 1811971666 | Brian P Kelly | Physical Therapist | 415 Crosslake Dr Ste B, Evansville, IN 47715 | 2005-12-05 |
| 1386286219 | Brian James Kelly | Pharmacist | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2019-10-11 |
| 1144794611 | Brian Kelly | Counselor | 140 High St Ste 230, Springfield, MA 01105-1435 | 2019-01-17 |
| Street Address |
11365 DORSETT RD. |
| City | MARYLAND HEIGHTS |
| State | MO |
| Zip Code | 63043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669809133 | Rachael Lisa Juehring | Psychologist | 11365 Dorsett Rd., Maryland Heights, MO 63043 | 2013-09-30 |
| 1972880003 | Mitzie E Graeler | General Acute Care Hospital | 11365 Dorsett Rd., Maryland Heights, MO 63043 | 2011-11-03 |
| 1902126097 | Rod Evan Pellenberg | Pediatrics | 11365 Dorsett Rd., Maryland Heights, MO 63043 | 2010-06-11 |
| 1346411212 | Barbara Ann Champion | Nurse Practitioner | 11365 Dorsett Rd., Maryland Heights, MO 63043 | 2008-03-18 |
| 1093925588 | Amy C. Zimmermann | Physical Medicine & Rehabilitation | 11365 Dorsett Rd., Maryland Heights, MO 63043 | 2007-05-23 |
| 1336367226 | Eugene Evra | Physical Medicine & Rehabilitation | 11365 Dorsett Rd., Maryland Heights, MO 63043 | 2007-04-23 |
| 1740304948 | Elizabeth R Downey | Registered Nurse | 11365 Dorsett Rd., Maryland Heights, MO 63043 | 2007-03-16 |
| 1558468892 | Connie D Simmons | Pediatrics | 11365 Dorsett Rd., Maryland Heights, MO 63043 | 2006-09-20 |
| 1285749333 | Lynda M Brady | Specialist | 11365 Dorsett Rd., Maryland Heights, MD 63043 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861026098 | Sana Lake Recovery Center, LLC | Community/Behavioral Health | 140 Weldon Parkway, Maryland Heights, MO 63043 | 2020-02-26 |
| 1124658257 | Amadu Barrie | Nurse Practitioner | 134 Midland Avenue, Maryland Heights, MO 63043 | 2020-01-16 |
| 1770004707 | Taylor Anne Jordan | Specialist/Technologist | 1885 Mckelvey Hill Dr., Apt 303, Maryland Heights, MO 63043 | 2017-06-29 |
| 1528507167 | Erica K Mazurkiewicz | Counselor | 12061 Dorsett, Maryland Heights, MO 63043 | 2017-02-15 |
| 1851756217 | Crpt, LLC | Physical Therapist | 12674 Dorsett Road, Maryland Heights, MO 63043 | 2015-12-29 |
| 1871930032 | Rachel Michele Gill | Chiropractor | 11d Worthington Access Dr., St. Louis, MO 63043 | 2013-05-29 |
| 1487913299 | John Martin Dds | Dentist | 12131 Dorsett, St 211, Maryland Heights, MO 63043 | 2012-05-14 |
| 1518287648 | Pharmacy Services Inc. | Pharmacist | 212 Millwell Dr., Suite A, St. Louis, MO 63043 | 2010-06-11 |
| 1447578000 | Rxoutreach | Pharmacy | 3171-3183 Riverport Tech Center Dr, Maryland Heights, MO 63043 | 2010-05-06 |
| 1811129257 | Gene Paul Barbour | Internal Medicine | 1 Reading, Marilyn Heights, MO 63043 | 2009-08-19 |
| Find all providers in zip 63043 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760586184 | Karen E Ruecker | Pediatrics | 11365 Dorsett Road, Maryland Heights, MO 63043 | 2006-09-08 |
| 1912134230 | Dawn Michelle Mcnamee | Pediatrics | 11365 Dorsett Road, Maryland Heights, MO 63043 | 2009-06-12 |
| 1831389618 | Jennifer E Kaufman | Pediatrics | 11365 Dorsett Road, Maryland Heights, MO 63043 | 2007-07-27 |
| 1679789952 | Elizabeth Sugarbaker | Pediatrics | 11365 Dorsett Rd, Maryland Heights, MO 63043-3411 | 2007-05-15 |
| 1568502557 | The Ranken-jordan Home for Convalescent Crippled Children | Pediatrics | 11365 Dorsett Rd, Maryland Heights, MO 63043-3411 | 2007-02-07 |
| 1558468892 | Connie D Simmons | Pediatrics | 11365 Dorsett Rd., Maryland Heights, MO 63043 | 2006-09-20 |
| 1720033814 | Paul F Grim IIi | Pediatrics | 11365 Dorsett Rd, Attention - Medical Staff Office, Maryland Heights, MO 63043-3411 | 2006-05-24 |
| 1841266749 | Nicholas A Holekamp | Pediatrics | 11365 Dorsett Rd, Maryland Heights, MO 63043-3411 | 2006-02-28 |
| 1275509226 | Rosa M Suarez-solar | Pediatrics | 11365 Dorsett Rd, Maryland Heights, MO 63043-3411 | 2006-02-28 |
| 1134195654 | Susan Conger | Pediatrics | 11365 Dorsett Rd, Maryland Heights, MO 63043-3411 | 2006-02-24 |
| Find all providers in MARYLAND HEIGHTS | ||||
| City | MARYLAND HEIGHTS |
| Zip Code | 63043 |
Please comment or provide details below to improve the information on DR. BRIAN J. KELLY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.