Tamara Jo Kelley, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704220283 Issued in MI

Practice address

3418 Mayapple LN Apt 11
Jackson, MI 49201-7286

Phone

(517) 240-9399

NPI assigned

Sep 13, 2011

Last updated

Jan 23, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Summit PointeGroup PAC ID 4587551189, 24 clinicians

Bronson-Acadia Joint Venture LLCGroup PAC ID 4688031578, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bronson Battle Creek Hospital Hospital, Battle Creek, MI, CCN 230075

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bronson-Acadia Joint Venture, LLC

  dba Bronson Behavioral Health Hospital

  • Psychiatric Hospital
  • Battle Creek, MI
  • NPI 1083337372
  Medicare reassignment Care Compare group NPD
• Summit Pointe

  • Psychiatry Physician
  • Battle Creek, MI
  • NPI 1700833555
  Medicare reassignment Care Compare group NPD
• W.a. Foote Memorial Hospital, Inc

  dba Henry Ford Allegiance Health

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1629000708
  Medicare reassignment NPD
• W.a. Foote Memorial Hospital

  dba Henry Ford Allegiance Health

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1366988347
  NPD
• W.a. Foote Memorial Hospital

  dba Henry Ford Allegiance Health

  • Physician Assistant
  • Jackson, MI
  • NPI 1538606348
  NPD
• Health Imperatives Inc.

  dba New Bedford Family Planning

  • Non-Surgical Family Planning Clinic/Center
  • New Bedford, MA
  • NPI 1013051614
  NPD (past)

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

• Bronson Battle Creek Hospital

  • General Acute Care Hospital
  • Battle Creek, MI
  • NPI 1083644579
  Care Compare affiliation

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1477835874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 FIRST STREET",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "49036",
            "telephone_number": "517-278-6942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3418 MAYAPPLE LN APT 11",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492017286",
            "telephone_number": "517-240-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "TAMARA",
        "middle_name": "JO",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704220283",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704220283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Michelle Kay, LMSW
• Barry J Keatley, D.C.
• Robin Lucasta Keefer Brigham, PA-C
• Johanna L Keller
• Martha Catherine Kelley, CSW
• Andrew Lee Kellogg, D.C.
• Marissa Kells, M.M., MT-BC
• Eric G Kelly, LLMSW
• Gwenda J Kelly, L.L.P.C
• Kathryn A Kelly, CRNA

• Nurse Practitioner in Jackson, MI
• Providers in Jackson, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.