MATTHEW THOMAS KELLY
NPI 1104717750
Student in an Organized Health Care Education/Training Program in Edmond, OK

Q: What is Matthew Kelly's NPI number?

The NPI number for Matthew Kelly is 1104717750. It was assigned to this individual provider in the NPPES registry on July 11, 2025. The provider is also known as Matt Thomas Kelly.

Q: What is Matthew Kelly's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Matthew Kelly was last updated on July 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 11, 2025

2709 NW 159TH ST, EDMOND, OK 73013(405) 696-3440 Get Directions Write a Review

NPPES record last updated: July 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Matthew Thomas Kelly NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MATTHEW THOMAS KELLY (NPI 1104717750) is an individual student in an organized health care education/training program in Edmond, Oklahoma and active in the NPI registry since July 2025.

NPPES Registry Identity

NPI1104717750

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameMATTHEW THOMAS KELLY

Location Address2709 NW 159TH STEdmond, OK 73013-1231

Mailing Address2709 Nw 159th StEdmond, OK 73013-1231 · (405) 696-3440

Phone(405) 696-3440

Sole ProprietorNo

Enumeration DateJuly 11, 2025

NPPES CertifiedJuly 11, 2025

✔ NPI 1104717750 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2709 NW 159TH ST, Edmond, OK 73013

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Other Names 1

Other Name (5)Matt Thomas Kelly

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Matthew Kelly's NPI number?

The NPI number for Matthew Kelly is 1104717750. It was assigned to this individual provider in the NPPES registry on July 11, 2025. The provider is also known as Matt Thomas Kelly.

Where is Matthew Kelly located?

Matthew Kelly practices at 2709 NW 159th St, Edmond, OK 73013. The listed phone number is (405) 696-3440.

What is Matthew Kelly's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Matthew Kelly was last updated on July 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.