John Wilson Kelly IV, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD51998 Issued in SC

Practice address

800 N Fant St
Anderson, SC 29621-5708

Phone

(864) 512-1000

NPI assigned

May 27, 2015

Last updated

Feb 5, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Internal Medicine

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

24 On Physicians PCGroup PAC ID 5698688141, 274 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Anmed Home Health Agency Home health agency, Anderson, SC, CCN 427032
• Anmed Health Hospital, Anderson, SC, CCN 420027

Merit-based Incentive Payment System (MIPS)

Final score

88.96 of 100Reported as group

Quality

77.5

Improvement activities

40

Cost

74.58

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkelly32058@direct.anmedhealth.net

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.

• 24 On Physicians, PC

  • Hospitalist Physician
  • Anderson, SC
  • NPI 1588613343
  Medicare reassignment Care Compare group NPD
• 24 On Physicians, P.C.

  • Hospitalist Physician
  • Attleboro, MA
  • NPI 1790104511
  NPD
• Anmed Health

  dba AnMed

  • General Acute Care Hospital
  • Anderson, SC
  • NPI 1417919531
  NPD (past)

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

• Anmed Health

  dba AnMed Home Health Agency

  • Home Health Agency
  • Anderson, SC
  • NPI 1376579474
  Care Compare affiliation
• Anmed Health

  dba AnMed

  • General Acute Care Hospital
  • Anderson, SC
  • NPI 1417919531
  Care Compare affiliation

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1194104802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 MEDITERRANEAN AVE",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296214293",
            "telephone_number": "803-427-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N FANT ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296215708",
            "telephone_number": "864-512-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Lothrop St",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152132536",
            "country_code": "US",
            "telephone_number": "412-647-8762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JOHN",
        "middle_name": "WILSON",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-27",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "MD51998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194104802",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gwendell McDaniel Kelley, APRN
• Margaret Kelley, FNP-BC
• Thomas E Kelley, RPH
• Scott A Kellner, MD
• Jimmie Marlene Kelly
• Laura A. Kelly, CRNA
• Natalie Anne Kelsey
• Sarah Elizabeth Kelton
• Rebecca Ann Kemp, APRN
• Kristin M. Kendall, SLP

• Internal Medicine Physician in Anderson, SC
• Providers in Anderson, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; 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.