JUSTIN KELLY, DC — NPI 1427520634 (Licensed & Credentialed Chiropractic Providers — Chiropractor, Sports Physician in ST. LOUIS, MO)

CMS-1500 Box 24J / 33a • NPI

1427520634

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

111NS0005X (CMS 35)

Licensed & Credentialed Chiropractic Providers — Chiropractor, Sports Physician

Box 32 Service Location & ZIP+4

8011 MARYLAND AVENUE, ST. LOUIS, MO, 63105

Official NPPES Practice Location

Practice Phone & Referral Fax

(989) 619-4839

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1427520634 (JUSTIN KELLY, DC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1427520634` (NPI-1 Individual Practitioner)
Provider / Legal Name	JUSTIN KELLY, DC
Plain-English Specialty	Licensed & Credentialed Chiropractic Providers — Chiropractor, Sports Physician NUCC Code: `111NS0005X` (Chiropractor, Sports Physician)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	8011 MARYLAND AVENUE, ST. LOUIS, MO, 63105
Practice Telephone / Fax	Tel: (989) 619-4839
Administrative Mailing Address	71 SAN TANA CT, CEDAR HILL, MO, 63016
Enumeration & Last Sync	Enumerated: 2018-12-28 \| CMS Record Updated: 2018-12-28

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

8011 MARYLAND AVENUE, ST. LOUIS, MO, 63105

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Plain-English Taxonomy & CMS Crosswalk (111NS0005X)

What Does Taxonomy Code 111NS0005X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 111NS0005X translates to:
"Licensed & Credentialed Chiropractic Providers — Chiropractor, Sports Physician"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 35 (Chiropractic)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Chiropractor, Sports Physician for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (JUSTIN KELLY, DC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`111NS0005X` — Chiropractor, Sports Physician Plain English: Licensed & Credentialed Chiropractic Providers — Chiropractor, Sports Physician	State: MO \| License: `111NS0005X` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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JUSTIN KELLY, DC (NPI #1427520634)