Derrick E Kelly
Individual provider Active NPI Driver · Indianapolis, IN
NPI 1346974896 · NPPES record last updated Jul 11, 2022
Key facts
- NPI
- 1346974896
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 6517 Royal Oakland Dr
Indianapolis, IN 46236-4805 - Phone
- (317) 657-9382
- NPI assigned
- Jul 11, 2022
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | IN | Yes |
Addresses
Primary practice location
6517 Royal Oakland Dr
Indianapolis, IN 46236-4805
Mailing address
6517 Royal Oakland Dr
Indianapolis, IN 46236-4805
Phone (317) 657-9382
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | dmcmedicaltransportation@gmail.com |
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.