NPIMap

Individual provider Active NPI

Tina M Kelley, NP-C

  • Family Nurse Practitioner
  • Washington, IN
National Provider Identifier
1821454356
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71006060A Issued in IN
Practice address
600 S State Road 57
Washington, IN 47501-4371
Phone
(812) 257-1052
Fax
(812) 996-7649
NPI assigned
Jan 13, 2016
Last updated
Mar 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71006060A IN
Family Nurse Practitioner 363LF0000X 71006060A IN Primary

Addresses

Primary practice location

600 S State Road 57
Washington, IN 47501-4371

Mailing address

PO Box 631767
Cincinnati, OH 45263-1767
Phone (812) 450-6815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160225000620 IN Practitioner - Nurse Practitioner 7911202148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Deaconess Clinic IncGroup PAC ID 3375610116, 411 clinicians

Practice addresses (Care Compare)

600 S State Rd
Suite 57
Washington, IN 47501-4371
Phone (812) 257-1052

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Memorial Medical Center Inc Current Accepting new patients
Deaconess Memorial Medical Center Inc CurrentSince Feb 8, 2016 Accepting new patients
Deaconess Clinic Inc Nurse Practitioner CurrentSince Jan 7, 2026 Accepting new patients
Deaconess Clinic, Inc Nurse Practitioner CurrentSince Jan 7, 2026 Accepting new patients
Deaconess Memorial Medical Center Inc CurrentSince Feb 8, 2016 Accepting new patients
Deaconess Memorial Medical Center Inc Nurse Practitioner Current Accepting new patients
Deaconess Memorial Medical Center Inc Past Accepting new patients

Locations

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

800 W 9th St
Jasper, IN 47546
Phone (812) 482-2345

1003 E Illinois St
Petersburg, IN 47567
Phone (812) 354-3458

4 NE 21st St
Ste 3
Washington, IN 47501
Phone (812) 257-1052

600 S State Road 57
Washington, IN 47501
Phone (812) 257-1052

600 S State Road 57
Ste A
Washington, IN 47501
Phone (812) 257-1052

Interoperability endpoints

  • Direct secure messaging: tkelley@mhhcc.gwaydirect.com
  • Direct secure messaging: tkelley86196@direct.deaconess.com

Organizations & group practices 8

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 8

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": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1821454356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631767",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452631767",
            "telephone_number": "812-450-6815",
            "fax_number": "812-450-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S STATE ROAD 57",
            "city": "WASHINGTON",
            "state": "IN",
            "postal_code": "475014371",
            "telephone_number": "812-257-1052",
            "fax_number": "812-996-7649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "TINA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-13",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71006060A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006060A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, IN

Sources for this page

Verify at the official NPI Registry.