Meredith Susanne Kelly (NPI# 1295200574, PAC ID# 1759634447) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1295200574 |
| PAC ID by PECOS | 1759634447 |
| Professional Enrollment ID | I20181025003032 |
| Full Name | Meredith Susanne Kelly |
| Organization Legal Name | GRACE DIVINE, LLC |
| Address |
5256 E 65th St Indianapolis IN 46220-4819 |
| Phone Number | 3174290120 |
| Gender | F |
| Graduation Year | 2015 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 2264568377 |
| Number of Group Practice Members | 13 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 5256 E 65th St, Indianapolis, IN 46220-4819 | 3174290120 | GRACE DIVINE, LLC |
| Organization Legal Name | GRACE DIVINE, LLC |
| Physicians | 25 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tammy M Crace Browning | Physician Assistant | Grace Divine, LLC | 1919 E 52nd St, Suite 200, Indianapolis, IN 46205-1381 |
| Nikki Lynn Orourke | Nurse Practitioner | Grace Divine, LLC | 1919 E 52nd St, Suite 200, Indianapolis, IN 46205-1381 |
| Stephaine N Bryant Lipp | Nurse Practitioner | Grace Divine, LLC | 1919 E 52nd St, Suite 200, Indianapolis, IN 46205-1381 |
| India L Samuels | Nurse Practitioner | Grace Divine, LLC | 1919 E 52nd St, Suite 200, Indianapolis, IN 46205-1381 |
| Victoria Crawford | Nurse Practitioner | Grace Divine, LLC | 1919 E 52nd St, Suite 200, Indianapolis, IN 46205-1381 |
| Beth A Taylor | Nurse Practitioner | Grace Divine, LLC | 1919 E 52nd St, Suite 200, Indianapolis, IN 46205-1381 |
| Shaniece J Smith | Nurse Practitioner | Grace Divine, LLC | 1919 E 52nd St, Suite 200, Indianapolis, IN 46205-1381 |
| Jacqueline Sue Muncy | Nurse Practitioner | Grace Divine, LLC | 1919 E 52nd St, Suite 200, Indianapolis, IN 46205-1381 |
| Jasmina Cheeseman | Physician Assistant | Grace Divine, LLC | 1919 E 52nd St, Suite 200, Indianapolis, IN 46205-1381 |
| Margaret S Corbett | Physician Assistant | Grace Divine, LLC | 1919 E 52nd St, Suite 200, Indianapolis, IN 46205-1381 |
| Street Address |
5256 E 65TH ST |
| City | INDIANAPOLIS |
| State | IN |
| Zip | 46220-4819 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dana Matthews | Nurse Practitioner | Grace Divine, LLC | 5256 E 65th St, Indianapolis, IN 46220-4819 |
| Sarah Jean Kindler | Physician Assistant | Grace Divine, LLC | 5256 E 65th St, Indianapolis, IN 46220-4819 |
| Samantha D Deramo | Nurse Practitioner | Grace Divine, LLC | 5256 E 65th St, Indianapolis, IN 46220-4819 |
| Gloria Chidinma Nwachukwu | Nurse Practitioner | Grace Divine, LLC | 5256 E 65th St, Indianapolis, IN 46220-4819 |
| Teresa Ann Mcgrath | Nurse Practitioner | Grace Divine, LLC | 5256 E 65th St, Indianapolis, IN 46220-4819 |
| Emily L Tedrow | Nurse Practitioner | Grace Divine, LLC | 5256 E 65th St, Indianapolis, IN 46220-4819 |
| Brooke Nicole Curry | Physician Assistant | Grace Divine, LLC | 5256 E 65th St, Indianapolis, IN 46220-4819 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Suzanne Lappas | Nurse Practitioner | University Family Physicians, Inc. | 2625 E 62nd St, 2010 Iu Health Physicians Primary Care, Indianapolis, IN 46220-0037 |
| Bryce A Mohr | Family Medicine | University Family Physicians, Inc. | 2625 E 62nd St, 2010 Iu Health Physicians Primary Care, Indianapolis, IN 46220-0037 |
| Mark D Bruns | Internal Medicine | University Family Physicians, Inc. | 2625 E 62nd St, 2010 Iu Health Physicians Primary Care, Indianapolis, IN 46220-0037 |
| Tami S Krichiver | Clinical Psychologist | 6544 Ferguson St, Indianapolis, IN 46220-1178 | |
| James A Vuotto | Chiropractic | 2127 E 71st St, Back Pain Chiropractic, Indianapolis, IN 46220-1307 | |
| David C Frauman | Psychologist, Clinical | 819 E 64th St, Suite 214, Indianapolis, IN 46220-1657 | |
| Katharine G Slaughter | Clinical Social Worker | 819 E 64th St, Suite 242, Indianapolis, IN 46220-1672 | |
| Christina Mary Nudi | Nurse Practitioner | St Vincent Medical Group Inc | 6320 N College Ave, Indianapolis, IN 46220-1706 |
| Scott K Hasty | Optometry | Myeyedr Optometry of Indiana LLC | 804 Broad Ripple Ave, Indianapolis, IN 46220-1961 |
| John Austin Godfrey | Optometry | Myeyedr Optometry of Indiana LLC | 804 Broad Ripple Ave, Indianapolis, IN 46220-1961 |
| Find all physicians in zip 46220 | |||
| City | INDIANAPOLIS |
| Zip Code | 46220 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | INDIANAPOLIS + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.