Active NPI
John Michael Kelly, D.C.
- Chiropractor
- Saginaw, MI
National Provider Identifier
1801896444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- JK004908
- Practice address
- 4266 State St
Saginaw, MI 48603-4028 - Phone
- (989) 792-6702
- Fax
- (989) 792-1128
- NPI assigned
- Jul 26, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | JK004908 | MI | Primary |
Addresses
Primary practice location
4266 State St
Saginaw, MI 48603-4028
Mailing address
4266 State St
Saginaw, MI 48603-4028
Phone (989) 792-6702
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1535385 | Medicaid | MI | |
| 350005936 | Other | MI | RAILROAD MEDICARE |
| 0993966 | Other | MI | HEALTH PLUS |
| 950G350220 | Other | MI | BCBS PIN |
| 0G35022 | Other | MI | BCN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| JK004908 | MI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300147200000",
"number": "1801896444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4266 STATE ST",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486034028",
"telephone_number": "989-792-6702",
"fax_number": "989-792-1128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4266 STATE ST",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486034028",
"telephone_number": "989-792-6702",
"fax_number": "989-792-1128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "JOHN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-26",
"last_updated": "2011-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "JK004908",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1535385",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "350005936",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLUS",
"identifier": "0993966",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PIN",
"identifier": "950G350220",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCN",
"identifier": "0G35022",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saginaw, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.