Jeffrey Glen Kelley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1896 Issued in TN

Practice address

1840 Medical Center Pkwy
Suite 200
Murfreesboro, TN 37129-3199

Phone

(615) 217-1560

Fax

(615) 890-7838

NPI assigned

Dec 2, 2010

Last updated

Dec 11, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Murfreesboro Radiology and Nuclear Medicine Consultants PLLCGroup PAC ID 7719964063, 101 clinicians

Tennessee Interventional and Procedural Specialists PLLCGroup PAC ID 5092291948, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Thomas Rutherford Hospital Hospital, Murfreesboro, TN, CCN 440053

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Murfreesboro Radiology & Nuclear Medicine Consultants PLLC

  dba Mid-State Radiology

  • Diagnostic Radiology Physician
  • Murfreesboro, TN
  • NPI 1316043524
  Medicare reassignment Care Compare group
• Tennessee Interventional and Procedural Specialists PLLC

  • Vascular & Interventional Radiology Physician
  • Murfreesboro, TN
  • NPI 1598647380
  Medicare reassignment Care Compare group
• Advanced Diagnostic Imaging, PC

  dba AdvancedHealth

  • Internal Medicine Physician
  • Goodlettsville, TN
  • NPI 1093741464

  Physician Assistant

  Medicare reassignment NPD
• Advanced Diagnostic Imaging PC

  dba Ankle and Foot Centers of Nashville

  • Durable Medical Equipment & Medical Supplies
  • Lewisburg, TN
  • NPI 1922846559
  NPD
• Mid-State Neurosurgery PC

  • Specialist
  • Murfreesboro, TN
  • NPI 1407864697
  NPD (past)
• Middle Tennessee Imaging LLC

  • Diagnostic Radiology Physician
  • Dickson, TN
  • NPI 1770667289
  NPD (past)
• Radiology Alliance PC

  • Diagnostic Radiology Physician
  • Nashville, TN
  • NPI 1861478489

  Physician Assistant

  NPD (past)

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

• Saint Thomas Rutherford Hospital

  dba Ascension Saint Thomas Rutherford

  • General Acute Care Hospital
  • Murfreesboro, TN
  • NPI 1164590386
  Care Compare affiliation

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1821390436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 BUSINESS PARK CIR",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370723132",
            "telephone_number": "615-851-6033",
            "fax_number": "615-851-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 MEDICAL CENTER PKWY",
            "address_2": "SUITE 200",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371293199",
            "telephone_number": "615-217-1560",
            "fax_number": "615-890-7838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "JEFFREY",
        "middle_name": "GLEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-02",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q018735",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN",
            "identifier": "6026014",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meagan Keener, BCBA
• Mary Ann Keith-Marcus, ACNPC-AG
• Lindsay Michelle Keith, MD
• Allison Kellermann
• Elizabeth Kelley, PA-C
• Marnicia Kelley
• Kimberlyn Kellogg, DC
• Christopher Kellum, DDS
• Jesse Blake Kellum Jr., M.D.
• Amanda Rose Kelly

• Physician Assistant in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.