Healthcare Provider Details

I. General information

NPI: 1538549720
Provider Name (Legal Business Name): JOHN MICHAEL KELLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2015
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S CHERRY ST STE 850
DENVER CO
80246-1325
US

IV. Provider business mailing address

501 S CHERRY ST STE 850
DENVER CO
80246-1325
US

V. Phone/Fax

Practice location:
  • Phone: 303-233-4247
  • Fax:
Mailing address:
  • Phone: 303-233-4247
  • Fax: 713-690-1980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0005735
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberU0495
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: