Kelly Nicely

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71007005A Issued in IN

Practice address

1400 N Ritter Ave Ste 410
Indianapolis, IN 46219-3046

Phone

(317) 355-2700

NPI assigned

Mar 9, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kelly Cunningham Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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 1

Specialty

Nurse Practitioner

Education

University of Cincinnati College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Health at Home LLC Home health agency, Indianapolis, IN, CCN 157046
• Community Hospital of Anderson and Madison County Hospital, Anderson, IN, CCN 150113

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kcunningham7594@ecommunitydirect.com

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.

• Community Physicians of Indiana Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1619105244
  Medicare reassignment Care Compare group NPD
• Community Physicians of Indiana Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Carmel, IN
  • NPI 1992396337
  NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

• Community Health at Home, LLC

  • Home Health Agency
  • Indianapolis, IN
  • NPI 1730646589
  Care Compare affiliation
• Community Hospital of Anderson & Madison County, Inc

  • General Acute Care Hospital
  • Anderson, IN
  • NPI 1972500452
  Care Compare affiliation

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

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1043751167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N RITTER AVE STE 410",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462193046",
            "telephone_number": "317-355-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICELY",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-09",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28199070A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71007005A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcunningham7594@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "1400 N Ritter Ave Ste 410",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462193046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "CUNNINGHAM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amy Ni
• Yi Wen Ni
• Ryaan Niazi
• Melissa Hope Nice, NP
• Alexa Gabrielle Niceley, DO
• Jack E. Nicewander, D.D.S.
• Kellie Nichelson
• Nicholas Catton DDS LLC
• Nicholas F Hrisomalos MD PC
• Bryn Katherine Nicholas, BCABA

• Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.