Active NPI
John Peter Kieley, MD
- Internal Medicine Physician
- Peoria, AZ
National Provider Identifier
1649279654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 37509
- Practice address
- 13640 N Plaza del Rio Blvd
Suite 220
Peoria, AZ 85381-4846 - Phone
- (623) 876-3850
- Fax
- (623) 876-3809
- NPI assigned
- Jul 20, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 24317 | MN | |
| Internal Medicine Physician | 207R00000X | 37509 | AZ | Primary |
Addresses
Primary practice location
13640 N Plaza del Rio Blvd
Suite 220
Peoria, AZ 85381-4846
Mailing address
13640 N Plaza del Rio Blvd
Peoria, AZ 85381-4846
Phone (623) 876-3850
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0401788 | Other | MN | MEDICA |
| 616093000 | Medicaid | MN | |
| 110043935 | Other | MN | RR MEDICARE |
| HP15533 | Other | MN | HEALTH PARTNERS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200009600000",
"number": "1649279654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13640 N PLAZA DEL RIO BLVD",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853814846",
"telephone_number": "623-876-3850",
"fax_number": "623-876-3809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13640 N PLAZA DEL RIO BLVD",
"address_2": "SUITE 220",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853814846",
"telephone_number": "623-876-3850",
"fax_number": "623-876-3809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIELEY",
"first_name": "JOHN",
"middle_name": "PETER",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-20",
"last_updated": "2008-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MN",
"license": "24317",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AZ",
"license": "37509",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "0401788",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "616093000",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "110043935",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP15533",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.