Michael Timothy Kelley, MD

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

35048006K Issued in OH

Practice address

1166 Dublin Rd
Suite 400
Columbus, OH 43215-1030

Phone

(614) 544-4605

NPI assigned

Dec 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1306822812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8E BROAD ST 501",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432153435",
            "telephone_number": "614-486-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1166 DUBLIN RD",
            "address_2": "SUITE 400",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151030",
            "telephone_number": "614-544-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "MICHAEL",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "OH",
            "license": "35048006K",
            "primary": true
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "KY",
            "license": "39072",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0672811",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeannine Yvette Kelley
• Keyana Kelley, OD
• Leticia Hellena Kelley
• Madison Sophia Kelley
• Meagan Elizabeth Kelley, PTA
• Morgan Kelley, BSN
• Robert Delvon Kelley
• Stephanie Carter Kelley, PT, MS, PHD, OCS
• Sunny S Kelley
• Allison Kellogg, FNP-C

• Occupational Medicine Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Occupational Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; 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.