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WILLIAM S. KELLY MD PA NPI 1972566933


NPI Information

NPI: 1972566933
Provider Name: WILLIAM S. KELLY MD PA

Doing Business As: KERNERSVILLE PRIMARY CARE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
420 W MOUNTAIN ST
KERNERSVILLE, NC
ZIP 27284
Phone: (336) 993-1618
Get Directions

WILLIAM S. KELLY MD PA is a family medicine in Kernersville, NC. The provider is 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. WILLIAM S. KELLY MD PA NPI is 1972566933. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Kernersville Primary Care.

The provider's business location address is:

420 W MOUNTAIN ST
KERNERSVILLE, NC
ZIP 27284-534
Phone: (336) 993-1618
Fax: (336) 993-5512

The provider's authorized official is Joanelle V Kelly .
The authorized official title is Office Manager and has the following contact phone number (336) 993-1618.

The enumeration date for this NPI number is 4/10/2006 and was last updated on 10/24/2013.


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
1207QG0300XFamily MedicineGeriatric Medicine40743NORTH CAROLINANo
2207Q00000XFamily Medicine40743NORTH CAROLINAYes

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
12319708MEDICARE PIN
2890293KMEDICAIDNORTH CAROLINA
3080107394OTHERNORTH CAROLINARR MEDICARE

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: 5/5/2024

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