MR. JAMES PATRICK KELLY (NPI# 1174608442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174608442 |
| Entity Type | Individual |
| Full Name | MR. JAMES PATRICK KELLY |
| Credential | MD, MBA |
| Practice Address |
17022 Shandwick Lane Granger IN 46530 |
| Practice Telephone | 5742779156 |
| Practice Fax Number | 5742715639 |
| Mailing Telephone | 5742779156 |
| Mailing Fax Number | 5742715639 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2016-01-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1034778A | IN | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 01034778 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100193010A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083221949 | James Edward Kelly Jr. | Occupational Therapist | 45 Montcalm St, Ticonderoga, NY 12883-1343 | 2020-09-25 |
| 1053940676 | James Patrick Kelly Iv | Student in an Organized Health Care Education/Training Program | 705 Riley Hospital Dr., Ri-5837, Indianapolis, IN 46202 | 2020-04-06 |
| 1902328032 | James Kelly | Physician Assistant | 8200 Henry Ave Ste G1, Philadelphia, PA 19128-2953 | 2017-07-11 |
| 1245782408 | James Kelly | Psychologist | 170 Pearl St Se, Atlanta, GA 30316-1247 | 2016-11-03 |
| 1104215300 | James Kelly | Physical Therapist | 8937 Woodman Way, Sacramento, CA 95826-2140 | 2015-01-12 |
| 1447543087 | James Anthony Kelly | Family Medicine | 517 North Center St, Sabinal, TX 78881 | 2011-05-16 |
| 1184879983 | James Aaron Kelly | Dentist | 10833 Le Conte Avenue Room A0-156b Chs, Uc Regents Maxillofacial Prosthodontics, Los Angeles, CA 90095-1668 | 2008-11-20 |
| 1598930711 | James Christopher Kelly | Anesthesiology | 222 N 5th St Ste 202, Martins Ferry, OH 43935-1582 | 2008-04-29 |
| 1952592735 | James Gerard Kelly | Licensed Practical Nurse | 120 Loperwood Ln, Lagrange, OH 44050-9756 | 2007-08-06 |
| 1568669653 | James Edward Kelly | Psychiatry & Neurology | 29466-5 Pintail Drive, Easton, MD 21601 | 2007-07-02 |
| Street Address |
17022 SHANDWICK LANE |
| City | GRANGER |
| State | IN |
| Zip Code | 46530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821610783 | Michiana Weight Loss and Wellness Clinic LLC | Internal Medicine | 14304 Sr 23, Granger, IN 46530 | 2020-05-14 |
| 1609427921 | Stephen J Armet | Physical Therapist | 16733 Saratoga Ct, Granger, IN 46530 | 2019-09-27 |
| 1881177756 | Memorial Hospital of South Bend | General Acute Care Hospital | 3220 Beacon Parkway, Granger, IN 46530 | 2018-09-07 |
| 1922483635 | Kiley Ramer | Behavioral Analyst | 6910 N Main St Bldg 13c51, Granger, IN 46530 | 2015-07-23 |
| 1326439415 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 625 E University Dr., Granger, IN 46530 | 2015-02-10 |
| 1811302094 | Costco Wholesale Corporation | Pharmacy | 625 E. University Drive, Granger, IN 46530 | 2014-06-25 |
| 1255773255 | Tracy Joyce Abel | Behavioral Analyst | 12042 Covered Wagon Court, Granger, IN 46530 | 2013-07-19 |
| 1225376304 | George Youssef | Internal Medicine | 5610 Town Center Drive #14, Granger, IN 46530 | 2013-01-23 |
| 1033489596 | Rene Raul Arce Guarnaluse | Homeopath | Emilio Bayarri 50, Puzol, VALENCIA 46530 | 2011-12-30 |
| 1568747368 | Ranya Bouzou-kadi | Pharmacist | 13060 Adams, Granger, IN 46530 | 2011-10-13 |
| Find all providers in zip 46530 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063900249 | Patrick Finnan Vining | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 545 Barnhill Dr Emerson Hall 215, Indianapolis, IN 46202 | 2018-04-24 |
| 1588084685 | Ashish Pulikal | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 7120 Clearvista Dr Ste 5300, Indianapolis, IN 46256-5300 | 2014-04-16 |
| 1649602236 | John F Ansbro | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 6199 River Bluff Dr, Newburgh, IN 47630-8850 | 2013-08-06 |
| 1972895266 | Union Hospital, Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 351 Maiden Lane, Union Hospital, Inc., Terre Haute, IN 47804-4073 | 2011-05-05 |
| 1013219435 | Walter William Jolly | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 10101 Ditch Rd, Carmel, IN 46032-8897 | 2010-11-18 |
| 1407085228 | Alan Thomas Marty | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 214 W Water St, Newburgh, IN 47630-1159 | 2009-07-14 |
| 1336381680 | Giorgio Zanotti | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 10590 N Meridian St # 105, Indianapolis, IN 46290-1028 | 2009-04-01 |
| 1639337769 | Kyle W Yancey | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1100 Reid Pkwy Ste 240, Richmond, IN 47374-1157 | 2008-05-27 |
| 1316104839 | Jay B Patel | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 610 N Michigan St Ste 306, South Bend, IN 46601-1079 | 2008-05-21 |
| 1114122488 | Hannah Copeland | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 7910 W Jefferson Blvd Ste 102, Fort Wayne, IN 46804-4159 | 2007-06-18 |
| Find all providers with the same taxonomy | ||||
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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.