| Kevin Gerard Kelly, | |
|
13150 Highway 43, Suite 10, Russellville, AL 35653-4558 | |
| (256) 332-5901 | |
| (256) 332-6911 |
| Full Name | Kevin Gerard Kelly |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 49 Years |
| Location | 13150 Highway 43, Russellville, Alabama |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710972385 | NPI | - | NPPES |
| 000001253 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 8497 (Alabama) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Russellville Hospital | Russellville, AL | Hospital |
| Terrace Manor Nursing & Rehabilitation Center, Inc | Russellville, AL | Nursing home |
| Burns Nursing Home, Inc. | Russellville, AL | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Russellville Hospital Inc. | 3476878489 | 89 |
| Entity Name | Russellville Hospital Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780232314 PECOS PAC ID: 3476878489 Enrollment ID: O20191018002761 |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Gerard Kelly, 13150 Highway 43, Suite 10, Russellville, AL 35653-4558 Ph: (256) 332-5901 | Kevin Gerard Kelly, 13150 Highway 43, Suite 10, Russellville, AL 35653-4558 Ph: (256) 332-5901 |
Ryan Albert Gregorio, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 605 Gandy St Ne, Russellville, AL 35653 Phone: 256-332-8969 Fax: 256-332-8353 | |
Dr. Harry Willi Kuberg, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 15225 Highway 43 Ste F, Russellville, AL 35653 Phone: 256-331-9408 Fax: 256-331-9530 | |
Chenyi Jeffrey Chenyi, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 15225 Highway 43, Suite 1, Russellville, AL 35653 Phone: 256-311-2700 Fax: 256-311-2777 |