Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1710956065 Individual Practitioner Male Practitioner

Dr. Jack Leslie Kelley , MD

Surgery • Lafayette, IN

Professional Overview & Biography Verified Profile Summary

Dr. Jack Kelley, MD is a registered healthcare professional specializing in Surgery in Lafayette, IN. Practice services are available at 1500 SALEM ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1500 Salem St

Lafayette, IN 479042164

Telephone 7654488000
Fax 7654488337
Associated Practice Facility / Clinic
🏢 Arnett Clinic, Llc Facility NPI 1508920471

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Lafayette, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 24.0 Yrs
State Avg: 25.9 Yrs
Regional Practice Density
20 Specialists

Practicing in Lafayette, IN (657 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License IN 01022437A

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
KE80251002 (IN)
Medicaid State Provider ID
100230510 (IN)
Commercial Insurance / Payer ID Anthem Provider Number
000000197818 (IN)
Commercial Insurance / Payer ID Caqh Number
10825369 (IN)
Commercial Insurance / Payer ID Phcs Pid Number
9017025 (IN)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1003044520

Doctor of Medicine (M.D.)

Dr. Michelle Herberts , MD

Internal Medicine - Critical Care Medicine

NPI 1003270786

Doctor of Medicine (M.D.)

Betty Wellman , NP

Nurse Practitioner - Family

NPI 1003351750

Nurse Practitioner

Dr. Kathryn Stucker , MD

Student in an Organized Health Care Education/Training Program

NPI 1003495391

Doctor of Medicine (M.D.)

Dani'el Mckillip , RN

Registered Nurse - Obstetric, Inpatient

NPI 1003604265

Registered Nurse

Abigail Crum , FNP-BC

Nurse Practitioner - Family

NPI 1003687005

Family Nurse Practitioner (Board Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 23, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location July 23, 2012

Registered at 1500 SALEM ST, LAFAYETTE, IN 479042164 (Tel: 7654488000)

📍
Updated Business Mailing Address July 23, 2012

Registered at PO BOX 5545, LAFAYETTE, IN 479035545 (Tel: 7654488000)

👤
Provider Name / Credentials Updated July 23, 2012

Recorded as JACK KELLEY, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 23, 2012

Surgery (License #01022437A in IN)

🟢
Initial NPI Registration & Enumeration March 17, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1710956065
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 17, 2006
Last Update: July 23, 2012
Sole Proprietor: No

Mailing Address

Po Box 5545

Lafayette, IN 479035545

Phone: 7654488000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.