Individual provider Active NPI

Sharon S Kelley, MD

  • Obstetrics & Gynecology Physician
  • East Lansing, MI
National Provider Identifier
1295703197
Registry record updated Oct 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
SK056289 Issued in MI
Practice address
1560 Turf Lane
East Lansing, MI 48823-6392
Phone
(517) 484-3000
Fax
(517) 484-6358
NPI assigned
Mar 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X SK056289 MI Primary

Addresses

Primary practice location

1560 Turf Lane
East Lansing, MI 48823-6392

Mailing address

1560 Turf Lane
East Lansing, MI 48823-6392
Phone (517) 484-3000

Other practice location 1

1100 S Cedar St
Mason, MI 48854-2086
Phone (517) 484-3000

Other identifiers 6

IdentifierTypeStateIssuer
1011404OtherMIMCLAREN PROVIDER #
0331410OtherMIBCBS/BCN PROVIDER #
0770068OtherMIPHP FAMILYCARE PROVIDER #
3421721MedicaidMI
0700068OtherMIPHP PROVIDER #
160045104OtherMIRR MEDICARE PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SK056289MIMDObstetrics & Gynecology Physician

Interoperability endpoints

  • Direct secure messaging: sharonkelley@aog.allscriptsdirect.net

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1295703197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 TURF LANE",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488236392",
            "telephone_number": "517-484-3000",
            "fax_number": "517-484-6358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 TURF LANE",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488236392",
            "telephone_number": "517-484-3000",
            "fax_number": "517-484-6358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 S Cedar St",
            "address_purpose": "LOCATION",
            "city": "Mason",
            "state": "MI",
            "postal_code": "488542086",
            "country_code": "US",
            "telephone_number": "517-484-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "SHARON",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "SK056289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN PROVIDER #",
            "identifier": "1011404",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS/BCN PROVIDER #",
            "identifier": "0331410",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP FAMILYCARE PROVIDER #",
            "identifier": "0770068",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3421721",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP PROVIDER #",
            "identifier": "0700068",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PROVIDER #",
            "identifier": "160045104",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.