Active NPI
Kyle R. Speakman, MD
- Family Medicine Physician
- Marion, IN
National Provider Identifier
1104269240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 11017446A
- Practice address
- 1391 N Baldwin Avenue
Marion, IN 46952-1913 - Phone
- (765) 660-7900
- Fax
- (765) 671-7751
- NPI assigned
- Apr 8, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 11017446A | IN | Primary |
Addresses
Primary practice location
1391 N Baldwin Avenue
Marion, IN 46952-1913
Mailing address
330 N Wabash
Ste G20
Marion, IN 46952-2600
Phone (765) 660-7616
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000001021719 | Other | IN | ANTHEM |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kyle.speakman@mgh.eclinicaldirectplus.com |
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Indiana University School of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1391 N Baldwin Ave
Marion, IN 46952-1913
Phone (765) 660-7900
Hospital & facility affiliations
- Angels of Mercy Homecare
- Ascension at Home
- Marion General Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.82 of 100
- Quality
- 71.45
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.59
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11017446A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marion General Hospital | Family Medicine | Current | Accepting new patients |
| Marion General Hospital | Current | Accepting new patients |
Locations
4781 Kaybee Dr
Gas City, IN 46933
Phone (765) 660-7840
330 N Wabash Ave
Ste G-20
Marion, IN 46952
Phone (765) 660-7600
441 N Wabash Ave
Marion, IN 46952
Phone (219) 482-4577
1391 N Baldwin Ave
Marion, IN 46952
Phone (765) 660-7900
Interoperability endpoints
- kyle.speakman@mgh.eclinicaldirectplus.com
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Marion, IN
- NPI 1528099041
-
- General Acute Care Hospital
- Gas City, IN
- NPI 1760186373
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Marion, IN
- NPI 1265872972
-
- General Acute Care Hospital
- Gas City, IN
- NPI 1760186373
-
- General Acute Care Hospital
- Marion, IN
- NPI 1770679201
-
- Home Health Agency
- Pendleton, IN
- NPI 1942376843
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603065600000",
"number": "1104269240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 N WABASH",
"address_2": "STE G20",
"city": "MARION",
"state": "IN",
"postal_code": "469522600",
"telephone_number": "765-660-7616",
"fax_number": "765-651-7313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1391 N BALDWIN AVENUE",
"city": "MARION",
"state": "IN",
"postal_code": "469521913",
"telephone_number": "765-660-7900",
"fax_number": "765-671-7751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEAKMAN",
"first_name": "KYLE",
"middle_name": "R.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-08",
"last_updated": "2020-10-19",
"certification_date": "2020-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "11017446A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000001021719",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kyle.speakman@mgh.eclinicaldirectplus.com",
"affiliation": "N",
"address_1": "1391 N Baldwin Avenue",
"city": "Marion",
"state": "IN",
"country_code": "US",
"postal_code": "469521913",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Marion, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.