John Joseph Kelly, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301057968 Issued in MI

Practice address

115 S Evans St
Tecumseh, MI 49286-1949

Phone

(517) 423-9300

Fax

(517) 423-9400

NPI assigned

Nov 3, 2005

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://arrprd.metrohealth.net/fhir/api/FHIR/R4

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.

• John J Kelly MD PC

  • General Practice Physician
  • Ann Arbor, MI
  • NPI 1134301880
  NPD (past) Authorized official
• My Home Doctor,P.C.

  • Physical Disabilities Residential Treatment Facility
  • Ypsilanti, MI
  • NPI 1023047883
  NPD (past)
• Packard Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ypsilanti, MI
  • NPI 1205538584
  NPD (past)
• Packard Health, Inc.

  • Clinic/Center
  • Ann Arbor, MI
  • NPI 1609988245
  NPD (past)
• University Family Physicians

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1346374097
  NPD (past)

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318896000000",
    "number": "1295726628",
    "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": {
        "last_name": "KELLY",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2011-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301057968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0804610981",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4301057968",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Insight Counseling of Tecumseh
• Integrity Counseling and Center for Development, PC.
• Jeffrey a, Stickney,D.O. P C
• John Kelly, MD, PLLC
• Tammy S. Jordan, MSW
• William P Kelly, D.C.
• Linda M. Killian, N.P., R.N.C.
• Alyssa King
• Linda Sue Klavon, MS, RN, CS, ACNP-BC
• Leslie Ann Kovalski, L.P.C.

• 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 18, 2011; 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.