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KIM A KELLY M.D. P.C. NPI 1871957761


NPI Information

NPI: 1871957761
Provider Name: KIM A KELLY, M.D., P.C.
Classification: Prevention Professional - 405300000X
Entity Type: Organization
Address:
5875 ALLENTOWN RD
SUITLAND, MD
ZIP 20746
Phone: (301) 702-2003
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KIM A KELLY, M.D., P.C. is a prevention professional in Suitland, MD. The provider is prevention Professionals work in programs aimed to address specific patient needs, such as suicide prevention, violence prevention, alcohol avoidance, drug avoidance, and tobacco prevention. The goal of the program is to reduce the risk of relapse, injury, or re-injury of the patient. Prevention Professionals work in a variety of settings and provide appropriate case management, mediation, referral, and mentorship services. Individuals complete prevention professionals training for the population of patients with whom they work. KIM A KELLY, M.D., P.C. NPI is 1871957761. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

5875 ALLENTOWN RD
SUITLAND, MD
ZIP 20746-570
Phone: (301) 702-2003
Fax: (301) 702-2324

The provider's authorized official is Kim A Kelly .
The authorized official title is Owner and has the following contact phone number (301) 702-2003.

The enumeration date for this NPI number is 4/7/2016 and was last updated on 5/4/2017.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1405300000XPrevention ProfessionalD0039363MARYLANDYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
144400001OTHERMARYLANDBLUE CHOICE
2048510100MEDICAIDMARYLAND

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: 4/28/2024

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