KEVIN J. KELLY MD, PC (NPI# 1689868697) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689868697 |
| Entity Type | Organization |
| Organization Name | KEVIN J. KELLY MD, PC |
| Practice Address |
8145 Valleywood Ln Ste B Portage MI 49024-5296 |
| Practice Telephone | 2693249162 |
| Practice Fax Number | 2693756079 |
| Mailing Telephone | 2693249162 |
| Mailing Fax Number | 2693756079 |
| Enumeration Date | 2007-09-02 |
| Last Update Date | 2007-09-02 |
| Authorized Official Name | DR. KEVIN J KELLY (OWNER) |
| Authorized Official Telephone | 2693249162 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 039833 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM | 0390022 | 01 |
| MI | 4282408 | 05 |
| Street Address |
8145 VALLEYWOOD LN STE B |
| City | PORTAGE |
| State | MI |
| Zip Code | 49024-5296 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497398051 | Lindsay Marie Stauffer | Counselor | 8145 Valleywood Ln Ste B, Portage, MI 49024-5296 | 2019-10-25 |
| 1962068445 | Ruth Newhouse | Counselor | 8145 Valleywood Ln Ste B, Portage, MI 49024-5296 | 2019-05-10 |
| 1972168730 | Laura Schmidt | Social Worker | 8145 Valleywood Ln Ste B, Portage, MI 49024-5296 | 2019-05-07 |
| 1457879629 | Karen Martin | Counselor | 8145 Valleywood Ln Ste B, Portage, MI 49024-5296 | 2017-09-07 |
| 1487183455 | Awakenings Christian Counseling | Counselor | 8145 Valleywood Ln Ste B, Portage, MI 49024-5296 | 2017-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134774524 | Antonio Richard Barron | Physician Assistant | 5717 Oakland Dr Ste A, Portage, MI 49024 | 2019-08-03 |
| 1699279240 | Julie Lynn Griffin | Specialist/Technologist | Portage Northern High School, 1000 Idaho Ave, Portage, MI 49024 | 2018-03-20 |
| 1194255711 | Brittany Lynn Finkler | Audiologist | 576 Romence Rd Ste 121, Portage, MI 49024 | 2017-06-15 |
| 1164881207 | Family & Children Services, Inc. | Clinic/Center | 1302 W Milham Ave, Portage, MI 49024 | 2016-02-17 |
| 1497127716 | Huber Counseling, LLC | Counselor | 1591 West Centre Ave, Suite 102, Portage, MI 49024 | 2015-10-26 |
| 1659757466 | Marie Porter | Rehabilitation Practitioner | 5724 Alten St, Portage, MI 49024 | 2015-08-04 |
| 1063824860 | George Hughes | General Practice | 6630 Sunburst Dr, Portage, MI 49024 | 2014-05-28 |
| 1922358407 | Kimberly Lynn Ellrich | Speech-Language Pathologist | Storypoint, 3951 W Milham Ave, Portage, MI 49024 | 2012-09-12 |
| 1942593744 | Shamika Hall, Ph.d. & Associates, Pllc | Community/Behavioral Health | 7901 S. 12th St., Suite 201, Portage, MI 49024 | 2011-05-26 |
| 1306142815 | Jody Lynn Wrathall | Dentist | 3020 Old Centre Rd, Portage, MI 49024 | 2011-01-31 |
| Find all providers in zip 49024 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821278193 | Primary Care Clinic of Jackson, P.C. | Internal Medicine | 2218 Sugarloaf Ave, Portage, MI 49024-6771 | 2007-11-05 |
| 1548464035 | Amanda Rose Henry | Internal Medicine | 245 W Centre Ave, Portage, MI 49024-5331 | 2007-06-11 |
| 1245263623 | Shirani Damayanthi Wijay-samarasinha | Internal Medicine | 5829 S Westnedge Ave, Portage, MI 49002-1456 | 2006-07-08 |
| 1710942479 | Kevin James Kelly | Internal Medicine | 8145 Valleywood Ln, Suite B, Portage, MI 49024-5296 | 2006-04-18 |
| 1740267947 | Robert M. Soltysiak | Internal Medicine | 917 W. Milham Ave, Portage, MI 49024 | 2005-12-28 |
| 1972586592 | Maureen Onuigbo | Internal Medicine | 2725 Airview Blvd, Ste 105, Portage, MI 49002-1803 | 2005-11-29 |
| 1821099219 | Simon Hoogendyk | Internal Medicine | 401 W Kilgore Rd, Portage, MI 49002-1100 | 2005-08-09 |
| 1639681018 | Shazia Shivji | Internal Medicine | 6200 Central Ave, Portage, IN 46368-3702 | 2017-10-25 |
| 1851812572 | Shaun Sadruddin Mehdi | Internal Medicine | 6200 Central Ave, Portage, IN 46368-3702 | 2017-07-03 |
| 1841663754 | Inpatient Physician Group LLC | Internal Medicine | 3156 Willowcreek Rd, Portage, IN 46368-4424 | 2015-11-02 |
| Find all providers in PORTAGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.