Provider Type Icon

MR. TIMOTHY JOSEPH KELLY MD NPI 1730297748


NPI Information

NPI: 1730297748
Provider Name: MR. TIMOTHY JOSEPH KELLY, MD
Classification: Internal Medicine - 207RA0401X
Entity Type: Individual

Specialization: Addiction Medicine

PECOS Registration: Yes

Address:
7165 CLEARVISTA WAY
INDIANAPOLIS, IN
ZIP 46256
Phone: (317) 621-5100
Get Directions

MR. Timothy Joseph Kelly, MD is an addiction medicine internal medicine in Indianapolis, IN with 45 years of experience. The provider is an internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. MR. Timothy Joseph Kelly, MD NPI is 1730297748. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: INDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1979

The provider's business location address is:

7165 CLEARVISTA WAY
INDIANAPOLIS, IN
ZIP 46256-621
Phone: (317) 621-5100
Fax: (317) 621-7896

The NPI 1730297748 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/29/2006 and was last updated on 11/27/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine01028972INDIANANo
2207RA0401XInternal MedicineAddiction Medicine01028972INDIANAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000000872285OTHERINDIANAANTHEM
2000000078852OTHERINDIANAANTHEM
3100333150MEDICAIDINDIANA
4000000871759OTHERINDIANAANTHEM
5000000871726OTHERINDIANAANTHEM

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.