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Deactivated NPI 1255789145 Deactivated / Inactive NPI Male Practitioner

Lucas David Kelley

Technician, Other • Walker, MI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Lucas Kelley has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 01, 2016
NPI Deactivation Date October 30, 2024
Total Practice Duration ~8 Years of Practice (2016 – 2024)

Professional Overview & Biography Verified Profile Summary

Lucas Kelley was a registered Technician, Other practicing in Walker, MI. Throughout an active medical career spanning 8 years, Lucas Kelley provided care at the practice location at 321 MANZANA CT NW APT 3D until profile deactivation on 2024-10-30.

Practice Location & Contact Primary Location

Practice Address

321 Manzana Ct Nw Apt 3d

Walker, MI 495347158

Telephone 8104448317

Specialty Benchmarks & Practice Insights

Comparative analytics for Technician, Other in Walker, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 9.0 Yrs
Regional Practice Density
1 Specialists

Practicing in Walker, MI (3821 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

Technician, Other Primary Specialty

NUCC Taxonomy Code: 247200000X

A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user.

Career & Practice History Timeline

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

14 Historical Events
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NPI Profile Deactivated October 30, 2024

Record deactivated on October 30, 2024

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Updated Business Mailing Address October 10, 2023

Registered at 4829 E BELTLINE AVE NE STE 310, GRAND RAPIDS, MI 495259350 (Tel: 6162796414)

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 10, 2023

Behavior Technician

NPI Profile Active March 28, 2017

NPI status registered as active in NPPES database

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Updated Practice Location March 28, 2017

Registered at 668 3 MILE AVE NW, SUITE 2, GRAND RAPIDS, MI 49544 (Tel: 8104448317)

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Updated Business Mailing Address March 28, 2017

Registered at 728 PROSPECT AVE SE, GRAND RAPIDS, MI 495035344 (Tel: 8104448317)

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Provider Name / Credentials Updated March 28, 2017

Recorded as LUCAS KELLEY

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 28, 2017

Technician, Other

NPI Profile Active June 01, 2016

NPI status registered as active in NPPES database

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Updated Practice Location June 01, 2016

Registered at 321 MANZANA CT NW APT 3D, WALKER, MI 495347158 (Tel: 8104448317)

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Updated Business Mailing Address June 01, 2016

Registered at 321 MANZANA CT NW APT 3D, WALKER, MI 495347158 (Tel: 8104448317)

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Provider Name / Credentials Updated June 01, 2016

Recorded as LUCAS KELLEY

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 01, 2016

Technician, Other

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Initial NPI Registration & Enumeration June 01, 2016

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: 1255789145
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 01, 2016
Last Update: June 01, 2016
Deactivation Date: October 30, 2024

Mailing Address

321 Manzana Ct Nw Apt 3d

Walker, MI 495347158

Phone: 8104448317

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.