GORDON M KELLY MD NPI 1154314250

NPI Information

  • NPI: 1154314250
  • Provider Name: GORDON M KELLY, MD
  • Classification: Surgery - 208600000X
  • Entity Type: Individual
  • Address: 355 CLEAR CREEK PKWY
    SUITE 1003
    LAVONIA, GA
    ZIP 30553
  • Phone: (706) 356-4392

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NPI Details

Gordon M Kelly, MD is a surgery in Lavonia, GA. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. Gordon M Kelly, MD NPI is 1154314250. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

355 CLEAR CREEK PKWY
SUITE 1003
LAVONIA, GA
ZIP 30553-174
Phone: (706) 356-4392
Fax: (866) 787-6602

The enumeration date for this NPI number is 8/24/2005 and was last updated on 6/16/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208600000XSurgery0101257941VIRGINIANo
2208600000XSurgery33373GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
102BBCSVMEDICARE PINGEORGIA
2D18343MEDICARE UPINGEORGIA
3VVI525AMEDICARE PINVIRGINIA
4000429019CMEDICAIDGEORGIA
51154314250MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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