Kelly J Kiehm, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

35080525 Issued in OH

Practice address

3600 Olentangy River Rd
BLDG 480
Columbus, OH 43214-3437

Phone

(614) 300-1105

Fax

(614) 678-8851

NPI assigned

Oct 24, 2005

Last updated

Feb 19, 2020By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 7, 2025 through Nov 7, 2027

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Capital City Neurosurgery LLC

  • Neurological Surgery Physician
  • Columbus, OH
  • NPI 1346590445
  Authorized official Same address or phone
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1588654370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 OLENTANGY RIVER RD",
            "address_2": "STE 480",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143485",
            "telephone_number": "614-442-0700",
            "fax_number": "614-678-8851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 OLENTANGY RIVER RD",
            "address_2": "BLDG 480",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143437",
            "telephone_number": "614-300-1105",
            "fax_number": "614-678-8851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIEHM",
        "first_name": "KELLY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OH",
            "license": "35080525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000483231",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMEPOS",
            "identifier": "4982480003",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2647112",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice K Kiecolt-Glaser, PH.D
• Miranda Katherine Kiefer, D.O.
• Taylor Nicole Kiefer, BCBA
• Matthew Kieffer
• Samuel J. Kiehl, MD
• Brandon Armstrong Kiel, M.D.
• Julie C. Kielt, MD
• Matthew Kielt
• Troy Kienzle, PHARMD
• Amy Kies-Budzynski, QMHS-B

• Neurological Surgery Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Neurological Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.