THEODORE M. KELLEY MD
NPI 1154520823
Family Medicine in Locust, NC

Active since July 13, 2007PECOS Enrolled
95.35/100
CMS Quality Rating
123 PROFESSIONAL PARK DR, LOCUST, NC 28097(704) 403-6760 Get Directions Write a Review

NPPES record last updated: July 15, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 15, 2024, May 4, 2023, Mar 9, 2023 and 40 more (43 updates tracked since 2018).

About Theodore M. Kelley Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THEODORE M. KELLEY MD (NPI 1154520823) is an individual family medicine provider in Locust, North Carolina, licensed in North Carolina (2009-00823) and active in the NPI registry since July 2007. He is enrolled in Medicare PECOS, is affiliated with Carolinas Medical Center-northeast, and maintains a secondary practice location in Midland.

NPPES Registry Identity

NPI1154520823
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameTHEODORE M. KELLEYCredential: MD
Location Address123 PROFESSIONAL PARK DRLocust, NC 28097-7712
Mailing AddressPo Box 19305Charlotte, NC 28219-9305
Sole ProprietorNo
Medical School CMSUniversity Of Tennessee, Hsc, College Of MedicineGraduated 2007
Enumeration DateJuly 13, 2007
Last NPPES UpdateJuly 15, 202443 updates tracked since enumeration
NPI 1154520823 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in NC · 2009-00823
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
123 PROFESSIONAL PARK DR, Locust, NC 28097

Secondary Practice Location 1

Location 112925 Highway 601, Ste 300Midland, NC 28107-9535 · Phone (704) 888-3702

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Theodore M. Kelley Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9335271139
PECOS Enrollment IDI20100714000462
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 14

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
402 services204 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
154 services118 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
123 services70 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
75 services75 patients
Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
70 services15 patients
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211
This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.
48 services14 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Carolinas Medical Center-Northeast

Acute Care Hospitals · Concord, NC
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340001
Location920 Church St NConcord, NC 28025 · Cabarrus County
Emergency services Birthing friendly

Carolinas Medical Center/Behav Health

Acute Care Hospitals · Charlotte, NC
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340113
Location1000 Blythe BlvdCharlotte, NC 28203 · Mecklenburg County
Emergency services Birthing friendly

Stanly Regional Medical Center

Acute Care Hospitals · Albemarle, NC
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340119
Location301 Yadkin StAlbemarle, NC 28001 · Stanly County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28097 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.35/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality84.22
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 11

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers14 claims26 services$6.06 avg. paid by Medicare
Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each A4424
DME-Orthotic Devices · category DF010N
1 supplier11 claims220 services$4.60 avg. paid by Medicare
Skin barrier, wipes or swabs, each A5120
DME-Orthotic Devices · category DF010N
1 supplier11 claims275 services$0.22 avg. paid by Medicare
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
1 supplier12 claims360 services$4.69 avg. paid by Medicare
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152
Other-Enteral and Parenteral · category OB006N
1 supplier12 claims3,858 services$0.28 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier15 claims15 services$15.27 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
123 PROFESSIONAL PARK DR
LOCUST, NC 28097
Family Medicine
123 PROFESSIONAL PARK DR
LOCUST, NC 28097
Family Medicine
123 PROFESSIONAL PARK DR
LOCUST, NC 28097
Family Medicine
123 PROFESSIONAL PARK DR
LOCUST, NC 28097
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
123 PROFESSIONAL PARK DR
LOCUST, NC 28097
Nurse Practitioner
123 PROFESSIONAL PARK DR
LOCUST, NC 28097

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theodore Kelley's NPI number?

The NPI number for Theodore Kelley is 1154520823. It was assigned to this individual provider in the NPPES registry on July 13, 2007.

Where is Theodore Kelley located?

Theodore Kelley practices at 123 Professional Park Dr, Locust, NC 28097. The listed phone number is (704) 403-6760.

What is Theodore Kelley's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Theodore Kelley enrolled in Medicare?

Yes. Theodore Kelley is registered in the Medicare PECOS enrollment system.

What insurance does Theodore Kelley accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee, Blue Cross and Blue Shield of NC and Oscar Health Plan of North Carolina, Inc and 1 other insurer list Theodore Kelley as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Theodore Kelley affiliated with any hospitals?

According to CMS data, Theodore Kelley is affiliated with Carolinas Medical Center-Northeast, Carolinas Medical Center/Behav Health and Stanly Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Theodore Kelley was last updated on July 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.