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

Q: 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.

Q: What is Theodore Kelley's specialty?

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

Q: 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.

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: November 01, 2026.

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

On this page

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

Phone(704) 403-6760

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

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Secondary Practice Location 1

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

Medicare enrollment records show Theodore Kelley reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Carolinas Physicians Network Inc

Same address

Family Medicine

123 PROFESSIONAL PARK DR
Locust, NC 28097

Reassigned Medicare billing, North Carolina enrollment
Also billed through NPI 1619371697 (North Carolina)
1,646 clinicians in this Medicare group

NPI 1225268170 (704) 403-6760

The Charlotte-Mecklenburg Hospital Authority

3.3 mi

Family Medicine

12925 HIGHWAY 601, STE 300
Midland, NC 28107

Reassigned Medicare billing, North Carolina enrollment
1,534 clinicians in this Medicare group

NPI 1265869846 (704) 888-3702

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

47 services46 patients

Urine microalbumin (protein) analysis 82044

Urine microalbumin analysis is a test that measures the amount of a protein called albumin in your urine. This protein is usually present in very small amounts, but higher levels can indicate kidney issues. The test is non-invasive and involves a simple urine sample.

46 services45 patients

Creatinine level to test for kidney function or muscle injury 82570

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

46 services45 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

41 services31 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

38 services38 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

16 services16 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

16 services16 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

11 services11 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

Quality

84.22

Promoting Interoperability

100

Improvement Activities

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.

STEVEN EDWARD LUCAS MD

Family Medicine