NPIMap

Individual provider Active NPI

Angela Diane Kelley, D.O.

  • Internal Medicine Physician
  • Dubuque, IA
National Provider Identifier
1881654473
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
3562 Issued in IA
Practice address
1515 Delhi St
Ste 100
Dubuque, IA 52001-6320
Phone
(563) 557-9111
Fax
(563) 589-4046
NPI assigned
Mar 27, 2006
Last updated
Apr 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 3562 IA Primary

Addresses

Primary practice location

1515 Delhi St
Ste 100
Dubuque, IA 52001-6320

Mailing address

1515 Delhi St
Ste 100
Dubuque, IA 52001-6320
Phone (563) 557-9111

Other identifiers 2

IdentifierTypeStateIssuer
43522900MedicaidWI
465864MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20050715000555 IA Practitioner - Internal Medicine 7012943590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Unified Therapy Services, IncGroup PAC ID 7618985714, 124 clinicians

Practice addresses (Care Compare)

1515 Delhi St
Suite 100
Dubuque, IA 52001-6320
Phone (563) 557-9111

4025 Westmark Dr
Suite 100
Dubuque, IA 52002-2626
Phone (563) 583-9300

4135 Pennsylvania Ave
Dubuque, IA 52002-2628

4480 Utica Ridge Rd
Bettendorf, IA 52722-1644

4480 Utica Ridge Rd
Suite 160
Bettendorf, IA 52722-1637
Phone (563) 742-5950

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions12
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3562IAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Iowa Physicians Clinic Medical Foundation Internal Medicine CurrentSince May 4, 2025 Accepting new patients
Trinity Medical Center Internal Medicine Past Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

1515 Delhi St
Ste 100
Dubuque, IA 52001
Phone (319) 557-9111

Interoperability endpoints

  • Direct secure messaging: akelley140409@direct.unitypoint.org
  • Direct secure messaging: angela.kelley@grandrivermedicalgroup.eclinicaldirectplus.com

Organizations & group practices 4

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 9

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": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1881654473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 DELHI ST",
            "address_2": "STE 100",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016320",
            "telephone_number": "563-557-9111",
            "fax_number": "563-589-4046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 DELHI ST",
            "address_2": "STE 100",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016320",
            "telephone_number": "563-557-9111",
            "fax_number": "563-589-4046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "ANGELA",
        "middle_name": "DIANE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-27",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "3562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43522900",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "465864",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

Verify at the official NPI Registry.