Kelly Carlson, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

01076541A Issued in IN

Practice address

2030 W Boulevard
Kokomo, IN 46902-6079

Phone

(765) 454-0200

NPI assigned

Jul 5, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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 1

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

Loyola University of Chicago, Stritch School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent Kokomo Hospital, Kokomo, IN, CCN 150010
• Woodlawn Hospital Hospital, Rochester, IN, CCN 151313
• St Vincent Heart Center Hospital, Carmel, IN, CCN 150153
• Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084
• Community Howard Regional Health Inc. Hospital, Kokomo, IN, CCN 150007

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• St. Vincent Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Winchester, IN
  • NPI 1144513375
  Medicare reassignment Care Compare group
• St Vincent Medical Group Inc

  • Cardiovascular Disease Physician
  • Indianapolis, IN
  • NPI 1558686436
  NPD (past)

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

• Community Howard Regional Health, Inc

  • General Acute Care Hospital
  • Kokomo, IN
  • NPI 1902878994
  Care Compare affiliation
• St. Joseph Hospital & Health Center, Inc.

  • General Acute Care Hospital
  • Kokomo, IN
  • NPI 1780625442
  Care Compare affiliation
• St. Vincent Heart Center of Indiana, LLC

  • Special Hospital
  • Carmel, IN
  • NPI 1982681748
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1306898960
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  • General Acute Care Hospital
  • Avon, IN
  • NPI 1851833230
  Care Compare affiliation
• Woodlawn Hospital

  • Critical Access Hospital
  • Rochester, IN
  • NPI 1265413405
  Care Compare affiliation

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

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1538424601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 W BOULEVARD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 W BOULEVARD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469026079",
            "telephone_number": "765-454-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7447 W Talcott Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606313713",
            "country_code": "US",
            "telephone_number": "773-774-5020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-05",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01076541A",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036151894",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2014009027",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01076541A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelly.carlson.2@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "2030 W Boulevard",
            "city": "Kokomo",
            "state": "IN",
            "country_code": "US",
            "postal_code": "469026079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kylie Carden
• Cardinal Counseling, LLC
• Cardiosom, LLC
• Allison Cardwell
• Michael J Carl, MD
• Angel Carpenter, LCSW
• Cassie Carpenter, RBT
• Jessica Carpenter
• Krista K Carte
• Dominica Carter, RBT

• Cardiovascular Disease Physician in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Cardiovascular Disease Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; 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.