Active NPI
Keely R Phelps, PA-C
- Physician Assistant
- Indianapolis, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10001329A
- Practice address
- 1701 N Senate Blvd
RM Dg412
Indianapolis, IN 46202-1239 - Phone
- (317) 962-3886
- Fax
- (317) 963-5492
- NPI assigned
- Sep 23, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 99048685 | IN | |
| Physician Assistant | 363A00000X | 10001329A | IN | Primary |
Addresses
Primary practice location
1701 N Senate Blvd
RM Dg412
Indianapolis, IN 46202-1239
Mailing address
250 N Shadeland Ave
Indianapolis, IN 46219-4959
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000749492 | Other | IN | ANTHEM BC/BS PIN |
Other names 1
- Keely R Miller
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kphelps@direct.iuhealth.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10001329A | IN | MD | Physician Assistant |
| 99048685 | IN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America LLC | Current | Accepting new patients | |
| Cep America LLC | Current | Accepting new patients | |
| University Medical Diagnostic Associates, Inc. | Past | Accepting new patients | |
| Icem, LLC | Past | Accepting new patients |
Locations
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
13861 Olio Rd
Fishers, IN 46037
Phone (317) 338-7136
2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617
1000 N 16th St
New Castle, IN 47362
Phone (765) 521-0890
1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523
Interoperability endpoints
- kphelps@direct.iuhealth.org
Organizations & group practices 8
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.
-
- General Practice Physician
- Indianapolis, IN
- NPI 1326893777
-
- Emergency Medicine Physician
- Terre Haute, IN
- NPI 1285103671
-
- Pulmonary Disease Physician
- Indianapolis, IN
- NPI 1417285230
-
- General Practice Physician
- Indianapolis, IN
- NPI 1902032832
-
- Emergency Medicine Physician
- East Chicago, IN
- NPI 1336805563
-
- Emergency Medicine Physician
- Fort Lauderdale, FL
- NPI 1700747946
-
- Emergency Medicine Physician
- Indianapolis, IN
- NPI 1467788208
-
- Internal Medicine Physician
- Indianapolis, IN
- NPI 1861441537
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Indianapolis, IN
- NPI 1144266024
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739491200000",
"number": "1962785154",
"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": "1701 N SENATE BLVD",
"address_2": "RM DG412",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462021239",
"telephone_number": "317-962-3886",
"fax_number": "317-963-5492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHELPS",
"first_name": "KEELY",
"middle_name": "R",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-23",
"last_updated": "2025-02-14",
"certification_date": "2025-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "99048685",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10001329A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS PIN",
"identifier": "000000749492",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kphelps@direct.iuhealth.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1701 N Senate Blvd",
"address_2": "RM DG412",
"city": "Indianapolis",
"state": "IN",
"country_code": "US",
"postal_code": "462021239",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "KEELY",
"last_name": "MILLER",
"middle_name": "R",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; 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.