NPIMap

Individual provider Active NPI

Lawrence R Kelly, M.D.

  • Vascular & Interventional Radiology Physician
  • Louisville, KY
National Provider Identifier
1114058781
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
42926 Issued in KY
Practice address
3906 S Dupont SQ
Louisville, KY 40207-4647
Phone
(812) 282-3899
Fax
(812) 282-4172
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 42926 KY Primary

Addresses

Primary practice location

3906 S Dupont SQ
Louisville, KY 40207-4647

Mailing address

101 Hospital Blvd
Jeffersonville, IN 47130-3769
Phone (812) 282-3899

Other identifiers 4

IdentifierTypeStateIssuer
122620057OtherINMEDICARE
7100071920MedicaidKY
K0027182OtherKYMEDICARE
2004551630MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090610000350 KY Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 0840340071 Reassigns benefits to 2 organizations
I20100701000419 IN Practitioner - Diagnostic Radiology 0840340071 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
University of Louisville School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic Imaging Alliance of Louisville PSCGroup PAC ID 1951214220, 25 clinicians
First Urology PSCGroup PAC ID 3779572888, 56 clinicians

Practice addresses (Care Compare)

200 E Chestnut St
Louisville, KY 40202-1831
Phone (502) 629-7601

2051 Clevidence Blvd
Suite B
Clarksville, IN 47129-2278
Phone (812) 280-9145

300 High Point CT
Mount Washington, KY 40047-6560
Phone (502) 955-6129

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.41 of 100Reported as group
Quality
92.64
Improvement activities
40
Cost
68.19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
First Urology, PSC Diagnostic Radiology CurrentSince Dec 1, 2025 Accepting new patients
Diagnostic Imaging Alliance of Louisville PSC Diagnostic Radiology CurrentSince Jul 1, 2010 Accepting new patients
Scott Memorial Hospital Past Accepting new patients
Diagnostic X-Ray Physicians, PSC Diagnostic Radiology Past Accepting new patients
Scott Physician Group LLC Past Accepting new patients

Locations

3431 Solutions Ctr
Chicago, IL 60677

2051 Clevidence Blvd
Ste B
Clarksville, IN 47129
Phone (502) 629-2030

101 Hospital Blvd
Jeffersonvlle, IN 47130
Phone (812) 206-8196

3605 Northgate Ct
Ste 110
New Albany, IN 47150
Phone (812) 949-5749

234 E Gray St
Ste 850
Louisville, KY 40202

3906 S DuPont Sq
Louisville, KY 40207
Phone (502) 409-5580

5129 Dixie Hwy
Louisville, KY 40216
Phone (502) 447-3242

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

4915 Norton Healthcare Blvd
Ste 103
Louisville, KY 40241
Phone (502) 446-6640

300 High Point Ct
Mt Washington, KY 40047
Phone (502) 447-4595

Organizations & group practices 5

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1114058781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL BLVD",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303769",
            "telephone_number": "812-282-3899",
            "fax_number": "812-282-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3906 S DUPONT SQ",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074647",
            "telephone_number": "812-282-3899",
            "fax_number": "812-282-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LAWRENCE",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "KY",
            "license": "42926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "122620057",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100071920",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K0027182",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2004551630",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.