Active NPI
David W Kelley, D.O.
- Anesthesiology Physician
- Lafayette, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 02003370A
- Practice address
- 2600 Greenbush St
Lafayette, IN 47904-2477 - Phone
- (765) 448-8000
- NPI assigned
- Sep 27, 2006
- Last updated
- Oct 9, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | RT1190 | NH | |
| Critical Care Medicine (Anesthesiology) Physician | 207LC0200X | RT1190 | NH | |
| Anesthesiology Physician | 207L00000X | 02003370A | IN | Primary |
Addresses
Primary practice location
2600 Greenbush St
Lafayette, IN 47904-2477
Mailing address
PO Box 5545
Lafayette, IN 47903-5545
Phone (765) 448-8000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200910690 | Medicaid | IN | |
| 000000576532 | Other | IN | ANTHEM PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- At Still University of Health Sciences, College of Osteo Med, Kirksville, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10201 Kanis Rd
Little Rock, AR 72205-6203
Phone (501) 227-5050
624 Hospital Dr
Mountain Home, AR 72653-2955
Phone (870) 508-1000
761 Beard Dr
Mountain Home, AR 72653-2961
Phone (870) 508-6700
9500 Kanis Rd
Suite 401
Little Rock, AR 72205-6377
Phone (501) 227-9088
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02003370A | IN | MD | Anesthesiology Physician |
| RT1190 | NH | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Arkansas for Medical Sciences | Current | Accepting new patients | |
| University of Arkansas for Medical Sciences | Anesthesiology | Current | Accepting new patients |
| University of Arkansas for Medical Sciences | Current | Accepting new patients | |
| Arkansas Children's Hospital | Current | Accepting new patients | |
| Arkansas Anesthesia Associates, PLLC. | Anesthesiology | Current | Accepting new patients |
| University of Arkansas for Medical Sciences | Anesthesiology | Current | Accepting new patients |
| Arkansas Childrens Hospital | Current | Accepting new patients | |
| Youngs Professional Services LLC | Current | Accepting new patients | |
| Premier Anesthesia of Arkansas Professional Corporation | Anesthesiology | Current | Accepting new patients |
Locations
700 W Grove St
El Dorado, AR 71730
Phone (870) 863-2200
3215 N Northhills Blvd
Fayetteville, AR 72703
Phone (479) 463-1000
1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874
1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006
10301 Kanis Rd
Little Rock, AR 72205
Phone (501) 604-4151
4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278
4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278
2655 Northwinds Pkwy
Alpharetta, GA 30009
Phone (678) 690-7804
2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000
Organizations & group practices 9
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Anesthesiology Physician
- Benton, AR
- NPI 1497023360
-
dba ACH Physicians Billing Group
- Pediatrics Physician
- Little Rock, AR
- NPI 1598773079
-
- Anesthesiology Physician
- Fayetteville, AR
- NPI 1932519485
-
dba Childrens University Medical Group
- Pediatrics Physician
- Little Rock, AR
- NPI 1346230968
Anesthesiology
-
- Internal Medicine Physician
- Little Rock, AR
- NPI 1588654016
Anesthesiology
-
dba YPS Anesthesia Services
- Certified Registered Nurse Anesthetist
- New Iberia, LA
- NPI 1922178599
AR
-
- Children's Hospital
- Little Rock, AR
- NPI 1477561983
-
- Family Medicine Physician
- El Dorado, AR
- NPI 1023795051
-
dba Schmieding Developmental Center
- Developmental - Behavioral Pediatrics Physician
- Lowell, AR
- NPI 1407021280
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba BRMC Professional Fees
- General Acute Care Hospital
- Mountain Home, AR
- NPI 1033147921
-
dba Baxter Health
- General Acute Care Hospital
- Mountain Home, AR
- NPI 1881788933
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223510400000",
"number": "1023109022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5545",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479035545",
"telephone_number": "765-448-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 GREENBUSH ST",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479042477",
"telephone_number": "765-448-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "DAVID",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2008-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NH",
"license": "RT1190",
"primary": false
},
{
"code": "207LC0200X",
"taxonomy_group": "",
"desc": "Anesthesiology, Critical Care Medicine",
"state": "NH",
"license": "RT1190",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IN",
"license": "02003370A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200910690",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PROVIDER NUMBER",
"identifier": "000000576532",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2008; 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.