JOHN S. KELLY MD – NPI #1033104849
Internal Medicine

An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.

Health Care Provider Taxonomy Code for Internal Medicine

JOHN KELLY is a physician located in MICHIGAN CITY, IN. NPPES has assigned the NPI number 1033104849 to JOHN KELLY on September 19, 2005. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 207RG0300X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Geriatric Medicine

The NPI profile was previously updated about 2 years ago on Feb 13, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JOHN KELLY below.

NPI Profile for
JOHN S. KELLY

NPI Number
1033104849
Enumeration Date

(more than 20 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
JOHN S. KELLY
Credentials
MD
Primary location
710 FRANKLIN ST
SUITE 200
MICHIGAN CITY, IN 46360-3563
Phone: (219) 872-6200 Fax: (219) 879-2915
1 Other location(s):
200 Alfred St
Michigan City, IN 46360
Phone: (219) 872-6200
Fax: (219) 879-2915
Mailing address
PO BOX 2000
DYER, IN 46311-0900
Phone: (219) 864-2107 Fax: (219) 864-2649
Sole Proprietor
No
Updated
Certification Date
Feb 12, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for JOHN KELLY

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidIN200030090
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RG0300X
- Internal Medicine / Geriatric Medicine (Primary)		 IN 01024423A

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
Content Type
Affiliation
N
Endpoint Location
710 FRANKLIN ST,
MICHIGAN CITY, IN 77025-1669

Additional Information

Education
INDIANA UNIVERSITY SCHOOL OF MEDICINE - Graduated 1972
Accepts Medicare
This provider accepts Medicare-approved amount as payment in full. The Medicare-approved amount is the total the provider can be paid. When a provider accepts the Medicare-approved amount as payment, you won't be billed for more than the Medicare deductible & coinsureance.
Medicare Ordering & Referring
Provider can:
  • Refer to Part B
  • Order Durable Medical Equipment
  • Refer to Home Health Agency
  • Order Power Mobility Devices
Affiliations
JOHN KELLY is affiliated with the following medical group(s):
  • HOSPITAL
    • FRANCISCAN HEALTH MICHIGAN CITY
      301 WEST HOMER
      MICHIGAN CITY, IN 46360
  • NURSING HOME
    • LIFE CARE CENTER OF MICHIGAN CITY
      802 US HIGHWAY 20 EAST
      MICHIGAN CITY, IN 46360

Why is my NPI data (personal information) being displayed publicly?
If you have an active NPI profile, your profile is required to be disclosed according to the FOIA and eFOIA. HIPAA also requires covered providers to share their NPI with other providers, health plans, clearinghouses and any entity that may need it for billing purposes.

How do I correct or change the NPI data displayed here?
At any time, providers can make changes to their NPI profile at NPPES. Login to NPPES to make changes online or call (800) 465-3203 for assistance. Changes made at NPPES will be reflected on this web site within a few days.

Can I hide my NPI profile from the public?
Unfortunately, No. The NPPES discloses health care provider data under the Freedom of Information Act to the public, which means anyone may request such information directly from the National Plan & Provider Enumeration System. See the complete CMS Data Dissemination Notice here.