Individual provider Active NPI

Brendan Nash Keleher, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Indianapolis, IN
National Provider Identifier
1720408123
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
01083916A Issued in IN
Practice address
7250 Clearvista Dr Ste 355
Indianapolis, IN 46256-5609
Phone
(317) 621-5676
NPI assigned
Apr 24, 2014
Last updated
Jun 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 2017-01867 NC
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 01083916A IN Primary

Addresses

Primary practice location

7250 Clearvista Dr Ste 355
Indianapolis, IN 46256-5609

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890

Other practice location 1

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 744-0750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171108002845 NC Practitioner - Internal Medicine 3476842519 Reassigns benefits to 1 organization
I20200713003337 IN Practitioner - Critical Care (Intensivists) 3476842519 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

7250 Clearvista Dr
Suite 355
Indianapolis, IN 46256-5609
Phone (317) 621-5676

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
N/ANCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Sep 1, 2017 Accepting new patients
Community Physicians of Indiana Inc Internal Medicine CurrentSince Jul 27, 2020 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jul 27, 2020 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

1515 N Madison Ave
Anderson, IN 46011
Phone (317) 870-0488

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

7250 Clearvista Dr
Ste 355
Indianapolis, IN 46256
Phone (317) 621-5673

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

111 Hospital Dr
Tarboro, NC 27886
Phone (252) 641-7700

Interoperability endpoints

  • Direct secure messaging: bkeleher412981@ecommunitydirect.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1720408123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7250 CLEARVISTA DR STE 355",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462565609",
            "telephone_number": "317-621-5676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Stantonsburg Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278342818",
            "country_code": "US",
            "telephone_number": "252-744-0750",
            "fax_number": "252-744-0392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELEHER",
        "first_name": "BRENDAN",
        "middle_name": "NASH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-24",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2017-01867",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "01083916A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.