Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

David Allen Kelly Jr., CRNP

Individual provider Family Nurse Practitioner · NPI 1639930779

David Allen Kelly Jr., CRNP is a Nurse Practitioner in Portland, Oregon. Qualified in 2021, 5 years ago. Practices with University of Penn-Medical Group, a 3,401-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
5
Licensed in
OR
In the registry since
2024
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

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Practice location Address checks out

3303 S Bond Ave
Portland, OR 97239-4501
Phone: (503) 494-6346
Fax: (503) 494-5385
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 202207583NP-PP (OR)

Record details

NPI number1639930779
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNP
Sole proprietorNo
NPI enumeratedJanuary 16, 2024
Last updated in NPPESMay 7, 2024
Certification dateMay 7, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice University Of Penn-Medical Group — 3401 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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