Individual provider Active NPI

Kelly R. Haisley, M.D.

  • Surgery Physician
  • Columbus, OH
National Provider Identifier
1154688323
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35136518 Issued in OH
Practice address
1800 Zollinger Rd
Columbus, OH 43221-2849
Phone
(614) 293-3230
Fax
(614) 293-4030
NPI assigned
Apr 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35136518 OH Primary

Addresses

Primary practice location

1800 Zollinger Rd
Columbus, OH 43221-2849

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-3230

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address khaisley753162@direct.osumc.edu

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191015003165 OH Practitioner - General Surgery 5698910396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Washington School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osu Surgery, LLCGroup PAC ID 0941105266, 207 clinicians

Practice addresses (Care Compare)

2050 Kenny Rd
Columbus, OH 43221-3502
Phone (614) 366-6675

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux88

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Osu Surgery, LLC Surgery CurrentSince Aug 24, 2019 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Ohio State University Hospitals Past Accepting new patients

Locations

2050 Kenny Rd
Columbus, OH 43221
Phone (614) 293-8054

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

300 W 10th Ave
Fl 4
Columbus, OH 43210
Phone (614) 293-8074

1800 Zollinger Rd
Fl 3
Upper Arlington, OH 43221
Phone (614) 293-2130

1800 Zollinger Rd
Upper Arlington, OH 43221
Phone (614) 293-2130

Interoperability endpoints

  • Direct secure messaging: khaisley753162@direct.osumc.edu

Organizations & group practices 3

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1154688323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-3230",
            "fax_number": "614-293-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 ZOLLINGER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432212849",
            "telephone_number": "614-293-3230",
            "fax_number": "614-293-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAISLEY",
        "first_name": "KELLY",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-12",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35136518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khaisley753162@direct.osumc.edu",
            "affiliation": "N",
            "address_1": "1800 Zollinger Rd",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432212849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.