MEDICARE: KELLIE BOYD BARNES MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	43055	KY
2	207Q00000X	Family Medicine Physician	35083658B	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740246073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLIE BOYD BARNES MD

Provider Business Mailing Address
First Line	:	632 BROADWAY PH 12
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10012-2614
Country	:	US
Telephone Number	:	347-294-3424
Fax Number	:

Provider Business Practice Location Address
First Line	:	632 BROADWAY PH 12
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10012-2614
Country	:	US
Telephone Number	:	347-294-3424
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	09/22/2022

Similar Medicare Providers

1346221660 — JUDITH HERTANU MD
Practice Location Address:

10 UNION SQ E , BETH ISRAEL MED CTR- DEPT OF REHAB MEDICARE
NEW YORK, NY
10003-3314

Practice Phone: 212-420-2757
Practice Fax:

1003770330 — ESTHER SANTANA BAZIL RN
Practice Location Address:

632 BROADWAY PH
NEW YORK, NY
10012-2614

Practice Phone: 800-731-4254
Practice Fax:

1033162854 — DENISE M. YOUNG-AJOSE MD, MPH
Practice Location Address:

632 BROADWAY PH
NEW YORK, NY
10012-2614

Practice Phone: 347-943-8131
Practice Fax:

1215976642 — FARNA BAPTISTE NP
Practice Location Address:

632 BROADWAY PH
NEW YORK, NY
10012-2614

Practice Phone: 347-933-6246
Practice Fax: 855-318-8277

1457365553 — DR. NAYAN R. SHAH M.D.
Practice Location Address:

632 BROADWAY PH 12
NEW YORK, NY
10012-2614

Practice Phone: 347-294-3414
Practice Fax:

1629085576 — MS. LINDA LAVERNE OTTLEY NP
Practice Location Address:

632 BROADWAY PH
NEW YORK, NY
10012-2614

Practice Phone: 800-731-4254
Practice Fax:

Directions to “ KELLIE BOYD BARNES MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.