Individual provider Active NPI

Kelly Marie Kremer, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Cincinnati, OH
National Provider Identifier
1881824795
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
01077138A Issued in IN
Practice address
3333 Burnet Ave # Mlc2015
Cincinnati, OH 45229-3026
Phone
(513) 636-4222
NPI assigned
Jul 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 55962 KY
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 35.126172 OH
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 01077138A IN Primary

Addresses

Primary practice location

3333 Burnet Ave # Mlc2015
Cincinnati, OH 45229-3026

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other identifiers 1

IdentifierTypeStateIssuer
201304070MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161108000964 IN Practitioner - Neurology 6507145943 Reassigns benefits to 1 organization
I20210216002250 OH Practitioner - Neurology 6507145943 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55962KYMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Medical Center CurrentSince Dec 10, 2020 Accepting new patients
Indiana Clinic-Neurology, LLC CurrentSince Nov 1, 2016 Accepting new patients
Major Hospital Past Accepting new patients
Children'S Hospital Medical Center Past Accepting new patients

Locations

3879 Reliable Pkwy
Chicago, IL 60686

3341 Solutions Ctr
Chicago, IL 60677

350 S Landmark Ave
Bloomington, IN 47403
Phone (812) 332-9874

705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

705 Riley Hospital Dr
#1340
Indianapolis, IN 46202
Phone (317) 948-7450

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

3333 Burnet Ave
Ste ML2015
Cincinnati, OH 45229

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

5899 Harrison Ave
Cincinnati, OH 45248
Phone (513) 803-8100

3333 Burnet Ave
#2015
Cincinnati, OH 45229
Phone (513) 636-4222

7777 Yankee Rd
Liberty Township, OH 45044
Phone (513) 803-9600

Interoperability endpoints

  • Direct secure messaging: kkremer38030@direct.eskenazihealth.edu
  • Direct secure messaging: kkremer26768@direct.uchealth.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1881824795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE # MLC2015",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREMER",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-27",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "KY",
            "license": "55962",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "OH",
            "license": "35.126172",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "IN",
            "license": "01077138A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201304070",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.