James M Kelly, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

036065101 Issued in IL

Practice address

555 W Court St
Suite 100
Kankakee, IL 60901-3664

Phone

(815) 932-7246

Fax

(815) 932-7307

NPI assigned

Dec 14, 2005

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• CPC Surgical Suite LLC

  • Pain Medicine (Anesthesiology) Physician
  • Kankakee, IL
  • NPI 1538719778
  NPD Authorized official
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)
• Joliet Pain Care Center

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Joliet, IL
  • NPI 1043322001
  NPD (past)

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1881679553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W COURT ST",
            "address_2": "SUITE 100",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013664",
            "telephone_number": "815-932-7246",
            "fax_number": "815-932-7307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W COURT ST",
            "address_2": "SUITE 100",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013664",
            "telephone_number": "815-932-7246",
            "fax_number": "815-932-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JAMES",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036065101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036065101",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050026565",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vijay Kata, MD
• Niketa Kataria, MD
• Charles Jonathan Kay, D.D.S.
• Keith M. Monson, M.D., SC
• Debbie Kelly, PTA
• Regan Lane Kendregan, PA
• Sana H Khadri, DO
• Muhammad Affan Khalid
• Samrat Umesh Khanna, MD
• Kidney Specialists of Kankakee LTD

• Specialist in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; 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.