Active NPI
Martin J. Kelly, M.D.
- Neonatal-Perinatal Medicine Physician
- Munster, IN
National Provider Identifier
1710951678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 36-085296
- Practice address
- 901 Macarthur Blvd
Munster, IN 46321-2901 - Phone
- (219) 836-4571
- Fax
- (219) 836-4596
- NPI assigned
- Feb 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 36-085296 | IL | Primary |
Addresses
Primary practice location
901 Macarthur Blvd
Munster, IN 46321-2901
Mailing address
901 Macarthur Blvd
Munster, IN 46321-2901
Phone (219) 836-4571
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36-085296 | IL | MD | Neonatal-Perinatal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459468800000",
"number": "1710951678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 MACARTHUR BLVD",
"city": "MUNSTER",
"state": "IN",
"postal_code": "463212901",
"telephone_number": "219-836-4571",
"fax_number": "219-836-4596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 MACARTHUR BLVD",
"city": "MUNSTER",
"state": "IN",
"postal_code": "463212901",
"telephone_number": "219-836-4571",
"fax_number": "219-836-4596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "MARTIN",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-15",
"last_updated": "2016-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "IL",
"license": "36-085296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Munster, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.