Kelly Kelly, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71004900A Issued in IN

Practice address

4100 Covert Ave
Evansville, IN 47714-5559

Phone

(812) 476-9983

Fax

(812) 437-6149

NPI assigned

May 20, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN, KY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Med Management Indiana PC 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Cost

67.33

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Med Management Indiana PC

  • Psychiatry Physician
  • Garfield Heights, OH
  • NPI 1225519333

  IN, KY

  Medicare reassignment Care Compare group NPD
• State of Indiana, Auditor of State

  • Psychiatric Hospital
  • Madison, IN
  • NPI 1700876224

  IN

  Medicare reassignment NPD
• Deer Oaks Mental Health Associates PC

  • Clinical Psychologist
  • Las Cruces, NM
  • NPI 1134175763

  KY

  Medicare reassignment NPD
• Mohammed S Adeel, MD

  • Physical Medicine & Rehabilitation Physician
  • Newburgh, IN
  • NPI 1467435099

  IN

  Medicare reassignment
• State of Indiana Auditor of State

  • Psychiatric Hospital
  • Evansville, IN
  • NPI 1235250788
  NPD
• State of Indiana, Auditor of State

  • Public Health or Welfare Agency
  • Indianapolis, IN
  • NPI 1023613403
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Deaconess Hospital Inc

  • General Acute Care Hospital
  • Newburgh, IN
  • NPI 1780535427

  Hospital

  Care Compare affiliation
• Deaconess Hospital, Inc.

  • General Acute Care Hospital
  • Evansville, IN
  • NPI 1053361642

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1003228446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 COVERT AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477145559",
            "telephone_number": "812-476-9983",
            "fax_number": "812-437-6149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 COVERT AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477145559",
            "telephone_number": "812-476-9983",
            "fax_number": "812-437-6149"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4480 N 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477103622",
            "country_code": "US",
            "telephone_number": "812-425-1525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KELLY",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71004900A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA",
            "identifier": "28184683A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer N Kelley, DPT
• Michael D Kelley, MD
• Tracey D Kelley, MSW LCSW
• Emily Claire Kellner, APRN, PMHNP-BC
• Brian P Kelly, DPT, SCS, ATC
• Sydney M Kelly, PA-C
• Tyler J. Kelly, DPM
• Elizabeth Grace Kemp, HIS
• Isaiah Brennan Kemper, MOT
• Quinn Kempf, DC

• All providers in Evansville, IN
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.