LAWRENCE BENNETT KELLY M.D. NPI 1629031901

NPI Information

  • NPI: 1629031901
  • Provider Name: LAWRENCE BENNETT KELLY, M.D.
  • Classification: Specialist - 174400000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4825 MACCORKLE AVE SW STE C
    SOUTH CHARLESTON, WV
    ZIP 25309
  • Phone: (304) 343-1022

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NPI Details

Lawrence Bennett Kelly, M.D. is a specialist in South Charleston, WV with 46 years of experience. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Lawrence Bennett Kelly, M.D. NPI is 1629031901. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1979

The provider's business location address is:

4825 MACCORKLE AVE SW STE C
SOUTH CHARLESTON, WV
ZIP 25309-365
Phone: (304) 343-1022
Fax: (304) 343-1025

The NPI 1629031901 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Psychotherapy with evaluation and management visit, 30 minutes (HCPCS:90833)
  • Psychotherapy with evaluation and management visit, 45 minutes (HCPCS:90836)
  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)

The enumeration date for this NPI number is 4/8/2006 and was last updated on 2/2/2024.

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
1174400000XSpecialist12306WEST VIRGINIAYes

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
1001720795OTHERWEST VIRGINIABLUE CROSS BLUE SHIELD
20114543001MEDICAIDWEST VIRGINIA
3260047649OTHERWEST VIRGINIAMEDICARE RAILROAD

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: 3/30/2025

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