NPIMap

Individual provider Active NPI

Jeremy Christopher Kelley, DO

  • Urology Physician
  • Winchester, VA
National Provider Identifier
1841584794
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
01022303215 Issued in VA
Practice address
1712 Amherst St
Winchester, VA 22601-2807
Phone
(540) 667-1712
Fax
(540) 665-0045
NPI assigned
Jun 7, 2011
Last updated
Jul 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 01022303215 VA Primary

Addresses

Primary practice location

1712 Amherst St
Winchester, VA 22601-2807

Mailing address

220 Campus Blvd Ste 100
Winchester, VA 22601-2896
Phone (540) 536-5100

Other practice location 1

1840 Amherst St
Winchester, VA 22601-2808
Phone (540) 536-8000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jkelley1009788@soc.inova.org
Direct Messaging Address jkelley1009788@soc.inova.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20190521002416 VA Practitioner - Urology 4486871449 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
West Virginia School of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Winchester Medical CenterGroup PAC ID 0244134021, 313 clinicians

Practice addresses (Care Compare)

1712 Amherst St
Winchester, VA 22601-2807
Phone (540) 667-1712

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.14 of 100Reported as group
Quality
83.98
Improvement activities
40
Cost
76.51

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01022303215VAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Medical Center CurrentSince Jul 11, 2022 Accepting new patients
Winchester Medical Center, Inc. Urology CurrentSince Jul 11, 2022 Accepting new patients
Shenandoah Valley Pathology Laboratories Inc Current Accepting new patients
Winchester Medical Center Current Accepting new patients
Winchester Medical Center Current Accepting new patients

Locations

1712 Amherst St
Winchester, VA 22601
Phone (540) 667-1712

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

220 Campus Blvd
Ste 100
Winchester, VA 22601

Interoperability endpoints

  • Direct secure messaging: jkelley1009788@valleyhealth.direct-ci.com

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 6

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": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1841584794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CAMPUS BLVD STE 100",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012896",
            "telephone_number": "540-536-5100",
            "fax_number": "540-536-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 AMHERST ST",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012807",
            "telephone_number": "540-667-1712",
            "fax_number": "540-665-0045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1840 Amherst St",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226012808",
            "country_code": "US",
            "telephone_number": "540-536-8000",
            "fax_number": "540-536-7780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "JEREMY",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "01022303215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkelley1009788@soc.inova.org",
            "affiliation": "N",
            "address_1": "1840 Amherst St",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226012808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkelley1009788@soc.inova.org",
            "affiliation": "N",
            "address_1": "1712 Amherst St",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226012807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.