Caitilin Kelly, M.D.

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

01034177 Issued in IN

Practice address

3161 S Highpoint LN
Bloomington, IN 47401-9605

Phone

(812) 287-8788

Fax

(812) 333-0725

NPI assigned

Nov 7, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Indiana University Health Bloomington Inc

  • Psychiatry Physician
  • Bloomington, IN
  • NPI 1871519074
  NPD

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1811066350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3161 S HIGHPOINT LN",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474019605",
            "telephone_number": "812-287-8788",
            "fax_number": "812-333-0725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3161 S HIGHPOINT LN",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474019605",
            "telephone_number": "812-287-8788",
            "fax_number": "812-333-0725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CAITILIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "01034177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10018446A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Keller, OD
• Olivia Keller
• Walt Keller, HSPP
• Bethany Lyndsey Kelley
• Michelle Kelley, RBT
• Isabella Kelly
• Jenna Kelly, RN
• Kathleen Ann Kelly
• Richard S Keltner, PA-C
• Mindy G Keltsch

• Critical Care Medicine (Internal Medicine) Physician in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Critical Care Medicine (Internal Medicine) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.