CPC Surgical Suite LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

CPC SURGICAL SUITE LLC

Practice address

555 W Court St Ste 100
Kankakee, IL 60901-3673

Phone

(815) 929-1520

Fax

(815) 614-3029

NPI assigned

Sep 19, 2019

Organization subpart

No

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

Authorized official

Name

Dr. James M Kelly, MDNPI 1881679553

Title

Doctor

Phone

(815) 929-1520

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James M Kelly, M.D.

  • Specialist
  • Kankakee, IL
  • NPI 1881679553
  NPD Authorized official

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584316800000",
    "number": "1538719778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W COURT ST STE 100",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013673",
            "telephone_number": "815-929-1520",
            "fax_number": "815-614-3029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W COURT ST STE 100",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013673",
            "telephone_number": "815-929-1520",
            "fax_number": "815-614-3029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CPC SURGICAL SUITE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-19",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "815-929-1520",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tiffany Cowger, PTA
• Carolyn Marie Cox, MS, ATC
• Wendy S. Crays, LCPC
• Cross Country Home Health LLC
• Brian Crowley, D.O.
• Claudia Grace Crumrine
• Kelly Lynn Cuffe, RD, LD, CDE

• Pain Medicine (Anesthesiology) Physician in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Pain Medicine (Anesthesiology) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.