Timothy James Kellie, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704285899 Issued in MI

Practice address

905 N Macomb St Ste 3
Monroe, MI 48162-3076

Phone

(734) 241-0560

Fax

(734) 241-3230

NPI assigned

Jan 24, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rehabilitation Specialists of Monroe P CGroup PAC ID 4981699501, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Promedica Monroe Regional Hospital Hospital, Monroe, MI, CCN 230099

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tkellie@rsompc-mi.direct.office.nextgen.com
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Rehabilitation Specialists of Monroe P C

  • Physical Medicine & Rehabilitation Physician
  • Monroe, MI
  • NPI 1255355871
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Memorial Hospital Corporatio

  dba Promedica Monroe Regional Hospital

  • General Acute Care Hospital
  • Monroe, MI
  • NPI 1811097223
  Care Compare affiliation
• Mercy Memorial Hospital Corporation

  dba Monroe Cancer Center

  • Specialist
  • Monroe, MI
  • NPI 1376997551

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1952848301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 N MACOMB ST STE 3",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481623076",
            "telephone_number": "734-241-0560",
            "fax_number": "734-241-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 N MACOMB ST STE 3",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481623076",
            "telephone_number": "734-241-0560",
            "fax_number": "734-241-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLIE",
        "first_name": "TIMOTHY",
        "middle_name": "JAMES",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-24",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704285899",
            "primary": false
        },
        {
            "code": "163WM1400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nurse Massage Therapist (NMT)",
            "state": "MI",
            "license": "7501000754",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501000754",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704285899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connie Sue Keller
• Elizabeth Marie Keller, S.T
• Natalie Keller
• Tammie L Kelley Stahr, RN
• Jennifer Ann Kelley, LMSW
• Charity Kelly
• Lisa Marie Kelly, APRN
• Oscar Kelly
• Ketamine Institute of Michigan (Ketamine Institute of Michigan South)
• Phyllis Ann Kettlewell, CRNA

• Nurse Practitioner in Monroe, MI
• Providers in Monroe, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.