TYLER P KELLY


Address: 250 E Day Rd, Suite 300, Mishawaka, IN 46545-3471
Phone: 5749680283

TYLER P KELLY (NPI# 1962818864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1962818864
Entity Type Individual
Full Name TYLER P KELLY
Credential NP
Practice Address 250 E Day Rd
Suite 300
Mishawaka
IN 46545-3471
Practice Telephone 5749680283
Practice Fax Number 5748555699
Mailing Telephone 5749680283
Mailing Fax Number 5748555699
Enumeration Date 2014-07-11
Last Update Date 2016-12-29
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
71005109A IN Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
IN APN PRESCRIPTIVE AUTHORITY 71005109A 01
IN CSR PRESCRIPTIVE AUTHORITY 71005109B 01
IN 201252820 05
IN RN LICENSE 28189341A 01

Other Providers TYLER KELLY

NPI Name Taxonomy Address Enumeration
1639401151 Tyler Justin Kelly Chiropractor 815 Grandview Ave, Ste 250, Columbus, OH 43215-1254 2010-02-09
1336667419 Tyler R Kelly Physical Therapy Assistant 1421 3rd St Sw, Roanoke, VA 24016-5204 2017-09-08
1689100935 Tyler Kelly Family Medicine 101 Dates Dr, Ithaca, NY 14850-1342 2017-05-05
1023458478 Tyler J. Kelly Podiatrist 225 Crosslake Dr, Evansville, IN 47715-8198 2013-06-30

Office Location

Street Address 250 E DAY RD
SUITE 300
City MISHAWAKA
State IN
Zip Code 46545-3471

Providers in the same location

NPI Name Taxonomy Address Enumeration
1114125945 Nephrology Inc. Clinic/Center 250 E Day Rd, Suit 300, Mishawaka, IN 46545-3471 2007-07-03
1386162709 Carrie Yarger Physical Therapist 250 E Day Rd, Mishawaka, IN 46545-3471 2017-09-06
1780106559 Lilian Kagendo Mwangi Nurse Practitioner 250 E Day Rd, Mishawaka, IN 46545-3471 2017-07-12
1003357377 Nephrology Physicians LLC Clinic/Center 250 E Day Rd, Suite 300, Mishawaka, IN 46545-3471 2017-03-20
1932645900 Kelly Stevens Occupational Therapist 250 E Day Rd, Mishawaka, IN 46545-3471 2017-01-13
1275079345 Genevieve Luther Physical Therapist 250 E Day Rd, Mishawaka, IN 46545-3471 2017-01-13
1346790235 North American Partners In Anesthesia Indiana LLC Anesthesiology 250 E Day Rd, Suite 300, Mishawaka, IN 46545-3471 2016-10-04
1144774738 Saint Joseph Pace Clinic/Center 250 E Day Rd, Mishawaka, IN 46545-3471 2016-08-11
1326310160 Mary-kate Oatman Nurse Practitioner 250 E Day Rd, Mishawaka, IN 46545 2012-02-08
1205163276 Fms Nephrology Partners North Central Indiana Dialysis Centers, LLC Clinic/Center 250 E Day Rd, Suite 300, Mishawaka, IN 46545-3471 2009-11-11
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1649824103 Senior Helpers In Home Supportive Care 230 Catalpa Drive Suite B, Mishawaka, IN 46545 2019-08-01
1093272114 Candice Marie Greathouse Physical Therapy Assistant 3630 Hickory Road, Mishawaka, IN 46545 2019-02-25
1639662596 Mishawaka Rcf Lp Assisted Living Facility 3630 Hickory Rd, Mishawaka, IN 46545 2018-06-14
1760907299 Timothy John Howard Emergency Medicine 610 1/2 N Main Street, Apartment 1, Mishawaka, IN 46545 2017-08-05
1699203612 Paridhie Vasudevan Dentist 6502 Grape Rd Ste 882, Mishawaka, IN 46545 2017-06-03
1780134650 Ossip Optometry, PC Optometrist 5111 N. Main Street, Suite 200, Mishawaka, IN 46545 2016-10-04
1457730038 Melissa Anne Douthit Nurse Practitioner 3665 Park Pl W Ste 300, Mishawaka, IN 46545 2015-05-28
1558759654 Spine and Joint Associates of Plymouth, Inc Chiropractor 229 Red Coach, Suite 106, Mishawaka, IN 46545 2014-12-26
1609264795 Spine and Joint Associates of Mishawaka, Inc Chiropractor 229 Red Coach Trail, Suite 106, Mishawaka, IN 46545 2014-12-26
1508260795 Maribel Smith Counselor 2989 Heritage Ct, Mishawaka, IN 46545 2014-10-16
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1467092908 Tori Driver Nurse Practitioner 3005 Grape Rd Ste B, Mishawaka, IN 46545-2709 2020-01-13
1093272593 Regina Lynn Yoder Nurse Practitioner 303 S Main St Ste 111, Mishawaka, IN 46544-2159 2019-02-21
1376021725 Kaley Michelle Marino Nurse Practitioner 1113 Mossy Ln, Mishawaka, IN 46544-9055 2018-07-29
1386192870 Melinda C Nwanganga Nurse Practitioner 4501 Lincolnway E, Mishawaka, IN 46544-4035 2016-09-14
1760835912 Ophelia Ansari Nurse Practitioner 4501 Linconway East, Mishawaka, IN 46544 2016-07-22
1457730038 Melissa Anne Douthit Nurse Practitioner 3665 Park Pl W Ste 300, Mishawaka, IN 46545 2015-05-28
1578692794 Lynn Davis Figg Nurse Practitioner 611 East Douglas Road, Suite 405, Mishawaka, IN 46545-1468 2007-03-05
1376557702 Patricia L Jackson Nurse Practitioner 230 W Catalpa Dr, Suite D, Mishawaka, IN 46545-8321 2006-07-28
1467406074 Saint Joseph Regional Medical Center, Inc. Nurse Practitioner 60101 Bodnar Blvd Ste 100b, Mishawaka, IN 46544-9340 2006-05-19
1518955327 Tori Dawn Clabaugh Nurse Practitioner 316 Indian Ridge Blvd, Mishawaka, IN 46545-9034 2005-10-06
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Competitor

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City MISHAWAKA
Zip Code 46545

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Dataset Information

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.

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