Meredith Susanne Kelly

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

71008472A Issued in IN

Practice address

5256 E 65TH St
Indianapolis, IN 46220-4819

Phone

(317) 429-0120

Fax

(866) 202-5499

NPI assigned

Oct 12, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1539302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1295200574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8954 GLASS CHIMNEY LN",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379438",
            "telephone_number": "317-501-0641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5256 E 65TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462204819",
            "telephone_number": "317-429-0120",
            "fax_number": "866-202-5499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MEREDITH",
        "middle_name": "SUSANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-12",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71008472A",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IN",
            "license": "71008472A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Rae Kelly, MSN
• Katherine J Kelly, M.D.
• Kesha Rae Kelly, NP
• Latonya R Kelly, OWNER
• Lindsay Kelly
• Morgan Kelly
• Nicholas Kelly, FNP-BC
• Parisa Mansoori Kelly, MD
• Patrick S Kelly, DDS
• Rebecca H Kelly, MD

• Primary Care Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Primary Care Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; 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.