Mike B Kelly, M.A., LIMHP, PLADC,

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

928 Issued in NE

Practice address

3810 Central Ave
Kearney, NE 68847-8134

Phone

(308) 237-5951

Fax

(308) 234-4018

NPI assigned

Dec 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Michael B. Kelly-Defreece Former name

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alegent Creighton HealthGroup PAC ID 1850285255, 137 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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.

• Alegent Creighton Health

  • Internal Medicine Physician
  • Omaha, NE
  • NPI 1033288923
  Medicare reassignment Care Compare group NPD
• Alegent Creighton Health

  • Community/Retail Pharmacy
  • Lincoln, NE
  • NPI 1598423220
  NPD

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1902967227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 CENTRAL AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688478134",
            "telephone_number": "083-237-5951",
            "fax_number": "308-234-4018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 CENTRAL AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688478134",
            "telephone_number": "308-237-5951",
            "fax_number": "308-234-4018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "616 W 5th St",
            "address_purpose": "LOCATION",
            "city": "Hastings",
            "state": "NE",
            "postal_code": "689015104",
            "country_code": "US",
            "telephone_number": "402-463-5684",
            "fax_number": "402-463-5686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MIKE",
        "middle_name": "B",
        "credential": "M.A., LIMHP, PLADC,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "P-939",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "2718",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NE",
            "license": "1446",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025451701",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "KELLY-DEFREECE",
            "middle_name": "B.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katherine A Keifer, MD
• Audrey Rebecca Keim, PT, DPT
• Susan Kay Keizer, MSED, RD, LMNT, CDE
• Natasha Nicole Kelley-Wise, APRN
• Ashley Kelley, CPSS
• Kemp Family Chiropractic PC
• Alexander Thomas Kemp, DC
• Travis Jay Kemp, DC
• Michelle L Kennedy, CRNA
• Casey R Kenny, MS-CCC-SLP

• Mental Health Counselor in Kearney, NE
• Providers in Kearney, NE by specialty
• Mental Health Counselor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.