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JODY L KELLY M.D. NPI 1932107208


NPI Information

NPI: 1932107208
Provider Name: JODY L KELLY, M.D.
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Individual
Organization: JODY L KELLY MD AND ASSOCIATES, LLC

PECOS Registration: Yes

CLIA Number: 14D0989753

Address:
2901 N. KNOXVILLE AVE.
PEORIA, IL
ZIP 61603
Phone: (309) 688-7010
Get Directions

Jody L Kelly, M.D. is an obstetrics gynecology in Peoria, IL with 27 years of experience. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. Jody L Kelly, M.D. NPI is 1932107208. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2901 N. KNOXVILLE AVE.
PEORIA, IL
ZIP 61603
Phone: (309) 688-7010
Fax: (309) 688-7044

The NPI 1932107208 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 CLIA number assigned to this NPI record is 14D0989753 - physician office with a certificate type of Certificate of Compliance.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Cervical or vaginal cancer screening; pelvic and clinical breast examination (HCPCS:G0101)
  • Ultrasound pelvis through vagina (HCPCS:76830)
  • Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory (HCPCS:Q0091)

The enumeration date for this NPI number is 7/12/2005 and was last updated on 12/7/2011.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207V00000XObstetrics & Gynecology036102228ILLINOISYes

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
1036102228MEDICAIDILLINOIS
2H37402MEDICARE UPINILLINOIS
3209281MEDICARE ID-TYPE UNSPECIFIEDILLINOIS

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: 11/14/2023

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.