Individual provider Active NPI

Elijah Kelley, DO

  • Family Medicine Physician
  • Huber Heights, OH
National Provider Identifier
1790365286
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.016091 Issued in OH
Practice address
8701 Old Troy Pike Ste 240
Huber Heights, OH 45424-1053
Phone
(937) 396-2880
Fax
(937) 396-2205
NPI assigned
Apr 9, 2021
Last updated
Jul 1, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34.016091 OH Primary

Addresses

Primary practice location

8701 Old Troy Pike Ste 240
Huber Heights, OH 45424-1053

Mailing address

8701 Old Troy Pike Ste 240
Huber Heights, OH 45424-1053
Phone (937) 396-2880

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ekelley744809@direct.ketteringhealth.org
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230607002715 OH Practitioner - Family Practice 0840699112 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Physicians IncGroup PAC ID 0840104360, 314 clinicians

Practice addresses (Care Compare)

8701 Old Troy Pike
Suite 240
Huber Heights, OH 45424-1053
Phone (937) 396-2880

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.016091OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Pathology, LLC Current Accepting new patients
Alliance Physicians Inc Family Medicine CurrentSince Aug 4, 2024 Accepting new patients
Alliance Physicians Inc CurrentSince Aug 4, 2024 Accepting new patients
Mercer County Joint Township Community Hospital CurrentSince May 2, 2023 Accepting new patients
Mercer County Joint Township Community Hospital CurrentSince May 2, 2023 Accepting new patients
Kettering Independent Medical Group Inc Family Medicine Past Accepting new patients

Locations

950 S Main St
Celina, OH 45822
Phone (419) 586-1611

800 W Main St
Coldwater, OH 45828
Phone (419) 678-2341

405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200

7740 Washington Village Dr
Ste 130
Dayton, OH 45459
Phone (513) 932-4891

8701 Old Troy Pike
Ste 240
Huber Heights, OH 45424
Phone (937) 233-4055

1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534

Organizations & group practices 6

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 5

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": "1617926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1790365286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8701 OLD TROY PIKE STE 240",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454241053",
            "telephone_number": "937-396-2880",
            "fax_number": "937-396-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8701 OLD TROY PIKE STE 240",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454241053",
            "telephone_number": "937-396-2880",
            "fax_number": "937-396-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "ELIJAH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-09",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.016091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ekelley744809@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "8701 Old Troy Pike Ste 240",
            "city": "Huber Heights",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454241053",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "8701 Old Troy Pike Ste 240",
            "city": "Huber Heights",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454241053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huber Heights, OH

Sources for this page

Verify at the official NPI Registry.