Tamara Jo Kelley, NP-C
Individual provider Active NPI Nurse Practitioner · Jackson, MI
NPI 1477835874 · NPPES record last updated Jan 23, 2020
Key facts
- NPI
- 1477835874
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 4704220283 (MI)
- Practice address
- 3418 Mayapple LN Apt 11
Jackson, MI 49201-7286 - Phone
- (517) 240-9399
- NPI assigned
- Sep 13, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 7
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Summit Pointe
Bronson-Acadia Joint Venture LLC
Practice addresses (Care Compare)
140 Michigan Ave W
Battle Creek, MI 49017-3602
140 W Michigan Ave
Battle Creek, MI 49017-3602
3630 Capital Ave SW
Suite 1
Batt;E Creel, MI 49015-7376
Phone (269) 979-8333
5550 Glenn Cross Rd
Battle Creek, MI 49015-4274
Phone (269) 256-4700
Hospital & facility affiliations
- Bronson Battle Creek Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200316000987 | MI | Practitioner - Nurse Practitioner | 7517395072 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704220283 | MI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Pointe | Current |
Accepting new patients | |
| W.a. Foote Memorial Hospital, Inc | Nurse Practitioner | Current |
Accepting new patients |
| Wa Foote Memorial Hospital, Inc | Nurse Practitioner | Current | Accepting new patients |
| Bronson-Acadia Joint Venture, LLC | Current |
Accepting new patients | |
| W.a. Foote Memorial Hospital, Inc | Current |
Accepting new patients | |
| Health Imperatives Inc. | Past |
Accepting new patients |
Locations
8472 Reliable Pkwy
Chicago, IL 60686
3630 Capital Ave SW
Ste 1
Battle Creek, MI 49015
Phone (269) 979-8333
5550 Glenn Cross Rd
Battle Creek, MI 49015
Phone (269) 256-4700
175 College St
Battle Creek, MI 49037
Phone (269) 966-1460
140 Michigan Ave W
Battle Creek, MI 49017
Phone (269) 966-1460
205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730
813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000
7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704220283 | MI | |
| Nurse Practitioner | 363L00000X | 4704220283 | MI | Yes |
Addresses
Primary practice location
3418 Mayapple LN Apt 11
Jackson, MI 49201-7286
Mailing address
141 First Street
Coldwater, MI 49036
Phone (517) 278-6942
Other providers in Jackson, MI
- Sydney Michelle Kay
- Barry J Keatley
- Robin Lucasta Keefer Brigham
- Johanna L Keller
- Martha Catherine Kelley
- Andrew Lee Kellogg
- Marissa Kells
- Eric G Kelly
- Gwenda J Kelly
- Kathryn A Kelly
All providers in Jackson, MI · Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.