John Kelly, MD, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

JK057968 Issued in MI

Legal business name

JOHN KELLY, MD, PLLC

Practice address

115 S Evans St
Tecumseh, MI 49286-1949

Phone

(517) 423-9300

Fax

(517) 423-9400

NPI assigned

Aug 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John J. Kelly, MD

Title

Physician

Phone

(517) 423-9300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414022400000",
    "number": "1265623748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S EVANS ST",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "492861949",
            "telephone_number": "517-423-9300",
            "fax_number": "517-423-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S EVANS ST",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "492861949",
            "telephone_number": "517-423-9300",
            "fax_number": "517-423-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN KELLY, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-08",
        "last_updated": "2014-10-23",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "517-423-9300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "JK057968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4970844",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luann M Hurd, C.R.C., L.P.C.
• Michelle Lynn Hutchison, LMSW
• Insight Counseling of Tecumseh
• Integrity Counseling and Center for Development, PC.
• Jeffrey a, Stickney,D.O. P C
• Tammy S. Jordan, MSW
• John Joseph Kelly, M.D.
• William P Kelly, D.C.
• Linda M. Killian, N.P., R.N.C.
• Alyssa King

• Family Medicine Physician in Tecumseh, MI
• Providers in Tecumseh, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.