DR. JAMES JOSEPH KELLEY IV (NPI# 1447646906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447646906 |
| Entity Type | Individual |
| Full Name | DR. JAMES JOSEPH KELLEY IV |
| Credential | D.O. |
| Practice Address |
2900 Acme Brick Plz Fort Worth TX 76109-4123 |
| Practice Telephone | 8178719069 |
| Practice Fax Number | 8178719067 |
| Mailing Telephone | 8178719069 |
| Mailing Fax Number | 8178719067 |
| Enumeration Date | 2015-04-11 |
| Last Update Date | 2020-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | S4991 | TX | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | NPI | 1447646906 | 01 |
| TX | TEXAS MEDICAL LICENSE | S4991 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376875294 | James Taylor Kelley | Pharmacist | 3945 Pole Line Rd, Attn: Pharmacy, Pocatello, ID 83201-5425 | 2010-02-02 |
| 1669640793 | James Edward Kelley II | Dentist | 1065 Johnnie Dodds Blvd Ste E, Mt Pleasant, SC 29464-6153 | 2008-02-11 |
| 1508087891 | James Kelley | Physical Therapist | 3137 Woodland Ct N, North Tonawanda, NY 14120-1154 | 2007-05-02 |
| 1285858159 | James M Kelley | Preventive Medicine | 3300 E Interstate 40, Suite 400, Amarillo, TX 79103-4801 | 2007-04-12 |
| 1831259050 | James P Kelley | Optometrist | 1727 Rt 27, Somerset, NJ 08873 | 2006-12-11 |
| 1033210240 | James E Kelley | Dentist | 5555 N Mesa St Ste 300, El Paso, TX 79912-5487 | 2006-09-26 |
| 1891757357 | James L Kelley | Pharmacist | 104 Holly St, Mc Gehee, AR 71654-2249 | 2006-04-03 |
| 1902361611 | James Patrick Thomas Kelley | Nurse Practitioner | 1200 E Main St Ste 12, Spartanburg, SC 29307-1738 | 2019-02-06 |
| 1881093698 | James Kelley | Physical Therapist | 75 Francis St, Asb II First Floor, Boston, MA 02115-6110 | 2014-08-18 |
| 1770902421 | James Fitzhugh Kelley | Family Medicine | 1001 S George St, Bldg Mkb, York, PA 17403-3676 | 2014-04-09 |
| Street Address |
2900 ACME BRICK PLZ |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76109-4123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275596538 | Michael G Waters | Urology | 2900 Acme Brick Plz, Fort Worth, TX 76109-4123 | 2006-04-08 |
| 1710597869 | Matthew Cavey Md Pa | Radiology | 2900 Acme Brick Plz, Fort Worth, TX 76109-4123 | 2020-08-04 |
| 1275157315 | Abby Lynne Cahill | Physician Assistant | 2900 Acme Brick Plz, Fort Worth, TX 76109-4123 | 2020-06-04 |
| 1376020842 | Kevin Daniel Schmitz | Urology | 2900 Acme Brick Plz, Fort Worth, TX 76109-4123 | 2018-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881156164 | Elizabeth Laborde Dds Pllc | Clinic/Center | 5656 Edwards Ranch Rd, Fort Worth, TX 76109 | 2019-04-04 |
| 1992273965 | Debra Cooper Lantz | Occupational Therapist | 4252 Bryant Irvin Road, Fort Worth, TX 76109 | 2018-11-08 |
| 1417434119 | Dermatology Specialists of Fort Worth Pllc | Dermatology | 6100 Southwest Blvd., Suite 100, Fort Worth, TX 76109 | 2018-07-25 |
| 1417446709 | Eating Recovery Center of Texas, LLC | Clinic/Center | 4200 S. Hulen Street, Suite #436, Ft. Worth, TX 76109 | 2018-05-02 |
| 1245751742 | Marissa Izabel San Miguel | Optometrist | 5912 Convair Dr Ste 208, Fort Worth, TX 76109 | 2017-07-05 |
| 1174910111 | Parkway Dental Professionals | Preferred Provider Organization | 4200 Bryant Irvin Rd. Ste. 101, Fort Worth, TX 76109 | 2015-04-16 |
| 1831583095 | Deborah K Lehmann, M.d. | Clinic/Center | 6420 Southwest Blvd., #128, Fort Worth, TX 76109 | 2015-03-26 |
| 1184036428 | Ft Worth Ranch Assist, LLC | Neurological Surgery | 3516 Ranch View Terrace, Fort Worth, TX 76109 | 2014-05-21 |
| 1821435538 | Metx LLC | Hearing Instrument Specialist | 4618 Sw Loop 820, Fort Worth, TX 76109 | 2013-06-04 |
| 1356608087 | Virginia Flores | Social Worker | 4208 Ranier Ct, Fort Worth, TX 76109 | 2012-04-19 |
| Find all providers in zip 76109 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023401510 | Robert A Bloom Md Pllc | Urology | 416 S. Henderson St., Fort Worth, TX 76104 | 2015-03-09 |
| 1538422779 | George C Bailey | Urology | 4312 Heritage Trace Pkwy Ste 700, Fort Worth, TX 76244 | 2012-06-22 |
| 1093998429 | Dallas/fort Worth Urology Consultants | Urology | 4809 Brentwood Stair Road, Fort Worth, TX 76103 | 2007-12-07 |
| 1982749164 | John W Johnson IIi | Urology | 6100 Harris Pkwy Ste 225, Fort Worth, TX 76132-4126 | 2007-02-21 |
| 1033262605 | Rajendra Singh Chouhan | Urology | 1115 Pennsylvania Ave, Suite A, Fort Worth, TX 76104-2153 | 2007-01-18 |
| 1164506226 | Charles Bamberger | Urology | 416 South Henderson, Fort Worth, TX 76104-1017 | 2006-10-25 |
| 1114968625 | David Lawrence Gould | Urology | 900 Jerome St Ste 304, Fort Worth, TX 76104-3941 | 2006-06-08 |
| 1275596538 | Michael G Waters | Urology | 2900 Acme Brick Plz, Fort Worth, TX 76109-4123 | 2006-04-08 |
| 1801859376 | Robert George Stroud | Urology | 1101 University Dr, Fort Worth, TX 76107-3012 | 2006-04-07 |
| 1811950397 | David R Rittenhouse | Urology | 1001 12th Ave Ste 140, Fort Worth, TX 76104-3926 | 2006-04-07 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76109 |
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| 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.