NPIMap

Individual provider Active NPI

Justin Kelley, D.O.

  • Orthopaedic Surgery Physician
  • Florence, SC
National Provider Identifier
1205256187
Registry record updated Sep 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
97318 Issued in SC
Practice address
1580 Freedom Blvd Ste 100
Florence, SC 29505-6074
Phone
(843) 413-6835
Fax
(843) 674-6312
NPI assigned
Apr 18, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Trauma Physician 207XX0801X 34.014089 OH
Student in an Organized Health Care Education/Training Program 390200000X
Orthopaedic Surgery Physician 207X00000X 34.014089 OH
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 97318 SC Primary

Addresses

Primary practice location

1580 Freedom Blvd Ste 100
Florence, SC 29505-6074

Mailing address

510 Rosewood Dr
Florence, SC 29501-5456
Phone (334) 399-9555

Other identifiers 2

IdentifierTypeStateIssuer
0381932MedicaidOH
34.014089OtherOHLICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.MUSC.edu Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200107000778 OH Practitioner - Orthopedic Surgery 7416258728 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Kansas City University of Physicians and Surgeons, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Coast Professional Company, LLCGroup PAC ID 6305810201, 105 clinicians

Practice addresses (Care Compare)

1401 Bone Creek Dr
Sandusky, OH 44870-7267
Phone (419) 625-4900

Hospital & facility affiliations

  • FRMC Home Health Services Home health agency, Sandusky, OH, CCN 367691
  • Firelands Regional Medical Center Hospital, Sandusky, OH, CCN 360025
  • Bellevue Hospital Hospital, Bellevue, OH, CCN 360107
  • Magruder Hospital Hospital, Port Clinton, OH, CCN 361314
  • Firelands Regional Medical Ctr Inpatient rehabilitation facility, Sandusky, OH, CCN 36T025

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement11
Knee replacement23
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.014089OHMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Coast Professional Company, LLC CurrentSince May 21, 2020 Accepting new patients
Ohiohealth Corporation CurrentSince Nov 5, 2019 Accepting new patients
North Coast Professional Company, LLC CurrentSince May 21, 2020 Accepting new patients
Ohiohealth Corporation CurrentSince Nov 5, 2019 Accepting new patients

Locations

1400 W Main St
Bellevue, OH 44811
Phone (330) 563-0641

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

5450 Frantz Rd
Ste 360
Dublin, OH 43016
Phone (614) 533-6497

703 Tyler St
Ste 352
Sandusky, OH 44870
Phone (419) 557-6785

1111 Hayes Ave
Sandusky, OH 44870
Phone (419) 557-7455

1401 Bone Creek Dr
Sandusky, OH 44870
Phone (419) 621-0035

Interoperability endpoints

  • Direct secure messaging: justin.kelley@fpg.medicity.net

Organizations & group practices 4

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 9

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": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788739200000",
    "number": "1205256187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 ROSEWOOD DR",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295015456",
            "telephone_number": "334-399-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 FREEDOM BLVD STE 100",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056074",
            "telephone_number": "843-413-6835",
            "fax_number": "843-674-6312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-18",
        "last_updated": "2026-09-07",
        "certification_date": "2026-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "OH",
            "license": "34.014089",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "34.014089",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "SC",
            "license": "97318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0381932",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "34.014089",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.MUSC.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1580 Freedom Blvd Ste 100",
            "city": "Florence",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295056074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.