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PETER KELLY LLC
NPI 1407514193
Family Medicine in Philadelphia, PA

Active since November 30, 2021
407 S 10TH ST STE 101, PHILADELPHIA, PA 19147(267) 223-0205(678) 487-5313 Get Directions Write a Review

NPPES record last updated: October 8, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 8, 2025, Feb 11, 2022, Feb 2, 2022 and 2 more (5 updates tracked since 2021).

About Peter Kelly Llc NPPES

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

PETER KELLY LLC (NPI 1407514193), doing business as Shamrock Medicine, is a healthcare organization registered as a family medicine in Philadelphia, Pennsylvania and active in the NPI registry since November 2021. The organization maintains 2 additional practice locations and lists Peter Kelly, Owner, as its authorized official.

NPPES Registry Identity

NPI1407514193
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePETER KELLY LLC
Location Address407 S 10TH ST STE 101Philadelphia, PA 19147-1274
Mailing Address407 S 10th St Ste 101Philadelphia, PA 19147-1274 · (215) 585-2342 · Fax (267) 376-4874
Phone(267) 223-0205
Fax(678) 487-5313
Organization SubpartNo
Authorized OfficialPeter KellyOwner · (267) 223-0205
Enumeration DateNovember 30, 2021
Last NPPES UpdateOctober 8, 20255 updates tracked since enumeration
NPPES CertifiedOctober 8, 2025
✔ NPI 1407514193 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
407 S 10TH ST STE 101, Philadelphia, PA 19147
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Other Names 1

Doing Business AsShamrock Medicine

Secondary Practice Locations 2

Location 1812 N Bethlehem Pike Ste 207ALower Gwynedd, PA 19002-2642 · Phone (215) 585-2342 · Fax (267) 376-4874
Location 2911 Kings Hwy SCherry Hill, NJ 08034-2522 · Phone (856) 553-1355 · Fax (267) 376-4874

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Peter Kelly Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Peter Kelly LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Jenny Pak
Nurse Practitioner
NPI 1174220636
407 S 10TH ST STE 101
Philadelphia, PA 19147
(215) 585-2342
✔ PECOSSame address
Peter Kelly, D.O.
Family Practice
NPI 1982869467
911 KINGS HWY S
Cherry Hill, NJ 08034
(856) 553-1355
✔ PECOS✔ Accepts Medicare8.5 mi
Joanna Swanson, APN
Nurse Practitioner
NPI 1265852248
237 CASTLEWOOD DR STE C
Murfreesboro, TN 37129
(615) 900-3435
✔ PECOS674 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Peter Kelly LLC's NPI number?

The NPI number for Peter Kelly LLC is 1407514193. It was assigned to this organization in the NPPES registry on November 30, 2021. The provider is doing business as Shamrock Medicine.

Where is Peter Kelly LLC located?

Peter Kelly LLC is located at 407 S 10th St Ste 101, Philadelphia, PA 19147. The listed phone number is (267) 223-0205.

What is Peter Kelly LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Peter Kelly LLC enrolled in Medicare?

Yes. Peter Kelly LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Peter Kelly LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Peter Kelly LLC, in Family Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Peter Kelly LLC was last updated on October 8, 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.