Active NPI
Michael Bryant Kelley, M.D.
- Cardiovascular Disease Physician
- Owensboro, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 52292
- Practice address
- 1301 Pleasant Valley Rd Ste 202
Owensboro, KY 42303 - Phone
- (270) 417-7500
- Fax
- (270) 417-7509
- NPI assigned
- Dec 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 60212959 | WA | |
| Cardiovascular Disease Physician | 207RC0000X | MD43981 | TN | |
| Cardiovascular Disease Physician | 207RC0000X | 52292 | KY | Primary |
Addresses
Primary practice location
1301 Pleasant Valley Rd Ste 202
Owensboro, KY 42303
Mailing address
PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 691-8070
Other practice location 1
3601 The Vanderbilt Clinic
Nashville, TN 37232-5100
Phone (615) 322-3000
Other practice location 2
3601 The Vanderbilt Clinic
Nashville, TN 37232-5100
Phone (615) 322-3000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130522000571 | TN | Practitioner - Cardiovascular Disease (Cardiology) | 7911177852 | Reassigns benefits to 1 organization |
| I20251222003234 | SC | Practitioner - Cardiovascular Disease (Cardiology) | 7911177852 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Harvard Medical School, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4600 McAuley PL
Blue Ash, OH 45242-4765
4600 McAuley PL
Suite 600
Blue Ash, OH 45242-4778
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52292 | KY | MD | Cardiovascular Disease Physician |
| 60212959 | WA | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bon Secours Medical Group Greenville Specialty Care LLC | Cardiovascular Disease | Current | Accepting new patients |
| Owensboro Health Medical Group Inc | Current | Accepting new patients | |
| Bon Secours Medical Group Greenville Specialty Care LLC | Current | Accepting new patients | |
| Owensboro Health Medical Group Inc | Current | Accepting new patients | |
| Owensboro Health Medical Group, Inc. | Current | Accepting new patients | |
| Vanderbilt University Medical Center | Family Medicine | Current | Accepting new patients |
| Inland Cardiology Associates, P.S. | Cardiovascular Disease | Past | Accepting new patients |
| Cardiology Associates of Spokane LLC | Cardiovascular Disease | Past | Accepting new patients |
Locations
Dept AT 40379
Atlanta, GA 31192
Dept A T 40379
Atlanta, GA 31192
2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352
2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351
1301 Pleasant Valley Rd
Ste 202
Owensboro, KY 42303
Phone (270) 417-7500
317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901
2 Innovation Dr
Ste 400
Greenville, SC 29607
Phone (864) 235-7665
2105 Edward Curd Ln
Franklin, TN 37067
Phone (615) 791-7250
200 Strahl St
Franklin, TN 37064
Phone (615) 550-5034
719 Thompson Ln
Ste 30330
Nashville, TN 37204
Phone (615) 936-3871
719 Thompson Ln
Nashville, TN 37204
Phone (615) 322-6485
Interoperability endpoints
- mkelley97790@direct.owensborohealth.org
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Hospice of Western Kentucky | Hospice | Corporate Director | Jan 1, 2021 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Community Based Hospice Care Agency
- Owensboro, KY
- NPI 1003892977
Corporate Director
Organizations & group practices 8
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.
-
- Cardiovascular Disease Physician
- Greenville, SC
- NPI 1821679580
Cardiovascular Disease, SC
-
- Internal Medicine Physician
- Nashville, TN
- NPI 1104202761
Family Medicine, TN
-
- Surgery Physician
- Greenville, KY
- NPI 1235518242
-
- Internal Medicine Physician
- Owensboro, KY
- NPI 1306700711
-
- Interventional Pain Medicine Physician
- Greenville, KY
- NPI 1043863509
-
- Orthopaedic Surgery Physician
- Fountain Inn, SC
- NPI 1760361174
-
- Cardiovascular Disease Physician
- Spokane, WA
- NPI 1609186121
Cardiovascular Disease
-
- Cardiovascular Disease Physician
- Spokane, WA
- NPI 1679522106
Cardiovascular Disease
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559174400000",
"number": "1376606830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 23229",
"city": "OWENSBORO",
"state": "KY",
"postal_code": "423043229",
"telephone_number": "270-691-8070",
"fax_number": "270-691-8026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 PLEASANT VALLEY RD STE 202",
"city": "OWENSBORO",
"state": "KY",
"postal_code": "42303",
"telephone_number": "270-417-7500",
"fax_number": "270-417-7509"
}
],
"practiceLocations": [
{
"address_1": "3601 The Vanderbilt Clinic",
"address_purpose": "LOCATION",
"city": "Nashville",
"state": "TN",
"postal_code": "372325100",
"country_code": "US",
"telephone_number": "615-322-3000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3601 The Vanderbilt Clinic",
"address_purpose": "LOCATION",
"city": "Nashville",
"state": "TN",
"postal_code": "372325100",
"country_code": "US",
"telephone_number": "615-322-3000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KELLEY",
"first_name": "MICHAEL",
"middle_name": "BRYANT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-18",
"last_updated": "2019-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "WA",
"license": "60212959",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "TN",
"license": "MD43981",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "KY",
"license": "52292",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Owensboro, KY
- Brenda Keller, OT
- John A Keller, CRNA
- Natalie Renee Keller, RDN, LD, CD
- Sarah F. Keller, APRN
- Kelley Fulkerson Counseling, LLC
- Julia Elaine Kennedy, PHARM.D., R.PH.
- Robert Leslie Kennedy, PHARM.D., R.PH.
- Kentuciana Hearing AIDS, Inc
- Kentuckiana Heart & Vascular Specialists PSC
- Kentuckiana Treatment Center for Anxiety & Ocd LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.