D MICHAEL KELLAM M.D. NPI 1982648937

NPI Information

NPI: 1982648937
Provider Name: D MICHAEL KELLAM, M.D.
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
800 E 20TH ST
SUITE 110
CHEYENNE, WY
ZIP 82001
Phone: (307) 634-7711
Get Directions

D Michael Kellam, M.D. is a diagnostic radiology radiology in Cheyenne, WY. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. D Michael Kellam, M.D. NPI is 1982648937. 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:

800 E 20TH ST
SUITE 110
CHEYENNE, WY
ZIP 82001-859
Phone: (307) 634-7711

The NPI 1982648937 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/16/2006 and was last updated on 7/9/2007.

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
1	2085R0202X	Radiology	Diagnostic Radiology	26458	COLORADO	No
2	2085R0202X	Radiology	Diagnostic Radiology	21264	NEBRASKA	No
3	2085R0202X	Radiology	Diagnostic Radiology	4219A	WYOMING	Yes

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
1	104015400	MEDICAID	WYOMING
2	303602	OTHER	WYOMING	BCBS OF WYOMING MRI
3	303602	MEDICARE ID-TYPE UNSPECIFIED	WYOMING	WY MRI MEDICARE NUMBER
4	477188	MEDICARE ID-TYPE UNSPECIFIED	COLORADO	CO MEDICARE NUMBER
5	E16211	MEDICARE UPIN
6	306010	OTHER	WYOMING	BCBS OF WYOMING CRG
7	360002827	MEDICARE ID-TYPE UNSPECIFIED		RR MEDICARE CRG
8	306010	MEDICARE ID-TYPE UNSPECIFIED	WYOMING	WY MEDICARE NUMBER
9	250002335	MEDICARE ID-TYPE UNSPECIFIED		RR MEDICARE MRI NUMBER
10	91042192	MEDICAID	COLORADO

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

NPI Synchronization or Removal

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