KELLY MEDICAL, PC (NPI# 1467495226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467495226 |
| Entity Type | Organization |
| Organization Name | KELLY MEDICAL, PC |
| Other Organization Name | KELLY FAMILY MEDICINE |
| Practice Address |
13921 N Meridian Ave Ste 100 Oklahoma City OK 73134-1106 |
| Mailing Address |
Po Box 268938 Oklahoma City OK 73126-8938 |
| Practice Telephone | 4057529600 |
| Practice Fax Number | 4057529650 |
| Mailing Telephone | 4057529600 |
| Mailing Fax Number | 4057529650 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2019-10-31 |
| Authorized Official Name | STEPHEN BLAKE KELLY (DOCTOR) |
| Authorized Official Telephone | 4057529600 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Kelly Family Medicine | Doing Business As Name - Organization |
| Street Address |
13921 N MERIDIAN AVE STE 100 |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73134-1106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841846474 | Designs In Dentistry | Dentist | 14810 Serenita Ave, Oklahoma City, OK 73134 | 2019-08-09 |
| 1538683248 | Amber N Rettke | Case Manager/Care Coordinator | 14900 N. Pennsylvania Ave Apt. 1423, Oklahoma City, OK 73134 | 2017-08-03 |
| 1043750755 | Nikki Jo Rios | Behavioral Analyst | 14828 Serenita Avenue, Oklahoma City, OK 73134 | 2017-02-28 |
| 1285092437 | Christina Almstrom Whelan | Psychologist | 14616 Fossil Creek Lane, Oklahoma City, OK 73134 | 2016-02-03 |
| 1881003614 | Amber D. Given | Counselor | 14001 Mcauley Blvd. Suite 240, Oklahoma City, OK 73134 | 2014-08-06 |
| 1114365483 | Chester Arthur Woods IIi | Student in an Organized Health Care Education/Training Program | 14548 North Pennsylvania Ave, Oklahoma City, OK 73134 | 2013-06-10 |
| 1700123916 | Laura Jane Holsey | Surgery | 3543 West Memorial Road, Holsey Cosmetic Surgery & Spa, Oklahoma City, OK 73134 | 2013-01-08 |
| 1023354842 | Amattco LLC | Clinic/Center | 3705 West Memorial Rd Suite 601, Oklahoma City, OK 73134 | 2012-12-26 |
| 1740531698 | Oklahoma Sports and Orthopedics Institute Pllc | Orthopaedic Surgery | 13401 N. Western. Ave., Ste. 301, Oklahoma City, OK 73134 | 2012-10-01 |
| 1003167503 | Lindsey Brockie | Technician, Other | 14828 Serenita Ave, Oklahoma City, OK 73134 | 2012-09-24 |
| Find all providers in zip 73134 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164039632 | Axiom Medical Solutions, LLC | Family Medicine | 14132 Se 134th St, Oklahoma City, OK 73165-7669 | 2020-09-28 |
| 1104437219 | L and M Investments LLC | Family Medicine | 6001 Nw 139th St, Oklahoma City, OK 73142-1919 | 2020-08-12 |
| 1235748617 | Brook Noel Leland | Family Medicine | 3329 Nw 22nd St, Oklahoma City, OK 73107-3021 | 2020-07-30 |
| 1043835176 | Thomas Patrick Owens IIi | Family Medicine | 900 Ne 10th Street, Oklahoma City, OK 73104-5420 | 2020-06-15 |
| 1730703562 | Michael Williamson | Family Medicine | 3500 Nw 56th St Ste 10, Oklahoma City, OK 73112-4529 | 2020-06-08 |
| 1295363620 | Saint Medical Group, LLC | Family Medicine | 3400 S Douglas Blvd Ste 307, Oklahoma City, OK 73150-1001 | 2020-03-31 |
| 1881220580 | Sarah Laing | Family Medicine | 1111 N Lee Ave Ste 305, Oklahoma City, OK 73103-2620 | 2020-03-14 |
| 1881225290 | Neans Lynn Denson | Family Medicine | 2815 Sw 119th St, Oklahoma City, OK 73170-2605 | 2020-02-04 |
| 1114563699 | Aim Health Clinics, LLC | Family Medicine | 2301 W I 44 Service Rd Ste 310, Oklahoma City, OK 73112-8729 | 2019-11-20 |
| 1841843265 | Stephanie N White | Family Medicine | 3400 Nw Expressway Bldg C-815, Oklahoma City, OK 73112-4493 | 2019-07-24 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73134 |
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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.