CHARLES WALTER KELLEY DPM NPI 1023010980

NPI Information

NPI: 1023010980
Provider Name: CHARLES WALTER KELLEY, DPM
Classification: Podiatrist - 213ES0131X
Entity Type: Individual

Specialization: Foot Surgery

Address:
3401 E RAYMOND ST
INDIANAPOLIS, IN
ZIP 46203
Phone: (317) 788-9769
Get Directions

Charles Walter Kelley, DPM is a foot surgery podiatrist in Indianapolis, IN. Charles Walter Kelley, DPM NPI is 1023010980. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3401 E RAYMOND ST
INDIANAPOLIS, IN
ZIP 46203-744
Phone: (317) 788-9769
Fax: (317) 781-4868

The enumeration date for this NPI number is 8/11/2005 and was last updated on 5/16/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0131X	Podiatrist	Foot Surgery	070000355	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	100058130	MEDICAID	INDIANA
2	065860	MEDICARE PIN	INDIANA
3	T34505	MEDICARE UPIN
4	0146750001	MEDICARE NSC	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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