Provider Demographics
NPI:1194724831
Name:KELLING, JAMES STEPHEN (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:STEPHEN
Last Name:KELLING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 214TH ST SE STE 300
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-4418
Mailing Address - Country:US
Mailing Address - Phone:425-412-7200
Mailing Address - Fax:
Practice Address - Street 1:187 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-4189
Practice Address - Country:US
Practice Address - Phone:828-884-9362
Practice Address - Fax:828-884-3851
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-01074207R00000X, 207RP1001X, 207RS0012X
WAMD61069919207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1477WOtherBCBS OF NC
NCP020681OtherGATEWAY HEALTH PLAN
NCNCM522COtherMEDICARE PTAN
A08344Medicare UPIN
NC2021853BOtherMEDICARE PTAN
NCNCM522AOtherMEDICARE PTAN
NCP00697523OtherRAILROAD MEDICARE PTAN