Individual provider Active NPI

Kelly Anne Kean, NP

  • Nurse Practitioner
  • Ann Arbor, MI
National Provider Identifier
1750653994
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704262007 Issued in MI
Practice address
1500 East Medical Center Drive
1H247 University Hospital
Ann Arbor, MI 48109-5048
Phone
(734) 936-4280
NPI assigned
Feb 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704262007 MI
Family Nurse Practitioner 363LF0000X 71007865A IN
Family Nurse Practitioner 363LF0000X 4704262007 MI
Nurse Practitioner 363L00000X 4704262007 MI Primary

Addresses

Primary practice location

1500 East Medical Center Drive
1H247 University Hospital
Ann Arbor, MI 48109-5048

Mailing address

3621 South State Street
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

Other practice location 1

550 University Blvd Ste 1250
Indianapolis, IN 46202-5149
Phone (317) 944-8231

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kkean@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231229002441 IN Practitioner - Nurse Practitioner 5991964827 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71007865AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC Nurse Practitioner CurrentSince Jul 1, 2025 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients
Nes Michigan, Inc. Past Accepting new patients

Locations

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000

550 University Blvd
Ste 1250
Indianapolis, IN 46202
Phone (317) 274-7372

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

Interoperability endpoints

  • Direct secure messaging: kkean@direct.iuhealth.org
  • Direct secure messaging: kkean1@direct.iuhealth.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1750653994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 SOUTH STATE STREET",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 EAST MEDICAL CENTER DRIVE",
            "address_2": "1H247 UNIVERSITY HOSPITAL",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095048",
            "telephone_number": "734-936-4280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 University Blvd Ste 1250",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025149",
            "country_code": "US",
            "telephone_number": "317-944-8231",
            "fax_number": "317-948-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEAN",
        "first_name": "KELLY",
        "middle_name": "ANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-03",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704262007",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71007865A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704262007",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704262007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkean@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "550 University Blvd Ste 1250",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.