Michael Kelly, R.PH

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302045631 Issued in MI

Practice address

1217 E Ireland Rd
South Bend, IN 46614-3448

Phone

(574) 291-0740

NPI assigned

Dec 12, 2017

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

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.

• Kroger Limited Partnership I

  • Community/Retail Pharmacy
  • South Bend, IN
  • NPI 1588737100
  NPD (past)
• Kroger Limited Partnership I

  • Community/Retail Pharmacy
  • Newport, KY
  • NPI 1104791078
  NPD (past)
• Rite Aid of Michigan Inc

  • Community/Retail Pharmacy
  • Buchanan, MI
  • NPI 1295844769
  NPD (past)
• Rite Aid of Michigan Inc

  • Community/Retail Pharmacy
  • Washington, MI
  • NPI 1619117405
  NPD (past)

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1356856348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9246 RED ARROW HWY",
            "city": "BRIDGMAN",
            "state": "MI",
            "postal_code": "491069591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 E IRELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466143448",
            "telephone_number": "574-291-0740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MICHAEL",
        "credential": "R.PH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-12",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "IN",
            "license": "26028514A",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302045631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Kelley, M.D.
• Samara Kelley
• Rebecca Kathleen Kelln, PA-C
• Jennifer Marie Kelly
• Lisa B Kelly, LCSW
• Patrick Kelly, COTA
• Starr E Kelly, O.T.
• Kathleen Kelsey, LCSW
• Brian Kemp
• Sydney Kempf

• Pharmacist in South Bend, IN
• Providers in South Bend, IN by specialty
• Pharmacist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.