John B Kelly, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

203883 Issued in AK

Practice address

3505 E Meridian Park Loop Ste 100
Wasilla, AK 99654-7242

Phone

(907) 416-6594

Fax

(800) 654-6250

NPI assigned

Jul 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY, AK2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Neurology

Education

University of Colorado School of Medicine, Aurora, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Northern Neurology LLCGroup PAC ID 6204377435, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mat-Su Regional Medical Center Hospital, Palmer, AK, CCN 020006
• Fairbanks Memorial Hospital Hospital, Fairbanks, AK, CCN 020012

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: northernneurologyllc.johnbkelly@159896.advancedmd-direct.com
• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.822

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.

• Northern Neurology, LLC

  • Neurology Physician
  • Wasilla, AK
  • NPI 1306684980
  Medicare reassignment Care Compare group
• Coastal Neurology and Neurosurgery, Inc

  • Neurological Surgery Physician
  • Anchorage, AK
  • NPI 1689927626
  Medicare reassignment NPD
• St Claire Medical Center, Inc.,

  • General Acute Care Hospital
  • Morehead, KY
  • NPI 1821168535
  Medicare reassignment NPD
• Neuroscience Associates of Northern Kentucky PSC

  • Primary Care Nurse Practitioner
  • Crestview Hills, KY
  • NPI 1215936240
  NPD Authorized official
• Christine Bailes, LLC

  • Family Nurse Practitioner
  • Wasilla, AK
  • NPI 1558806901
  Medicare reassignment
• Black & Carpenter PSC

  • Internal Medicine Physician
  • Morehead, KY
  • NPI 1770557936
  NPD
• Neuroscience Associates of Northern Kentucky,PSC

  • Interventional Pain Medicine Physician
  • Crestview Hills, KY
  • NPI 1588093694
  NPD
• St Claire Medical Center, Inc

  • Rural Health Clinic/Center
  • Morehead, KY
  • NPI 1477236487
  NPD
• St Claire Medical Center, Inc.,

  • Internal Medicine Physician
  • Morehead, KY
  • NPI 1801395520

  Neurology

  NPD
• Riverhills Healthcare Inc

  • Neurology Physician
  • Cincinnati, OH
  • NPI 1205943651
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fairbanks Memorial Hospital, LLC

  • General Acute Care Hospital
  • Fairbanks, AK
  • NPI 1720537178
  Care Compare affiliation
• Mat-Su Valley Medical Center LLC

  • General Acute Care Hospital
  • Palmer, AK
  • NPI 1417975061
  Care Compare affiliation

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1407855315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 E MERIDIAN PARK LOOP STE 100",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547242",
            "telephone_number": "907-416-6594",
            "fax_number": "800-654-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 E MERIDIAN PARK LOOP STE 100",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547242",
            "telephone_number": "907-416-6594",
            "fax_number": "800-654-6250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1405 Kellum St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fairbanks",
            "state": "AK",
            "postal_code": "997014189",
            "country_code": "US",
            "telephone_number": "907-416-6594",
            "fax_number": "800-654-6250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Old Seward Hwy Ste 301",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995036068",
            "country_code": "US",
            "telephone_number": "907-416-6594",
            "fax_number": "800-654-6250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JOHN",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AK",
            "license": "203883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740353",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wendi Kellar
• Samantha Keller, CDM
• Forrest Robert Kelley
• Ray Don Kelley, MD
• Kelly Maixner DMD LLC Dba Wee Care Pediatric Dentistry
• Shawn Kelly
• Ellen Christine Kelsey, M.S., CCC-SLP
• Elaina L Kemp
• Heather Kemp, RN
• Sabrina Kendall, LMT

• Neurology Physician in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Neurology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.

Verify at the official NPI Registry.