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DR. MICHAEL EARL KELLY D.O.
NPI 1164474631
Family Medicine in Watervliet, MI

Active since May 16, 2006
420 MEDICAL PARK DR, WATERVLIET, MI 49098(269) 463-3600(269) 463-5356 Get Directions Write a Review

NPPES record last updated: September 29, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Michael Earl Kelly D.o. NPPES

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

DR. MICHAEL EARL KELLY D.O. (NPI 1164474631) is an individual family medicine provider in Watervliet, Michigan, licensed in Michigan (5101009399) and active in the NPI registry since May 2006.

NPPES Registry Identity

NPI1164474631
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. MICHAEL EARL KELLYCredential: D.O.
Location Address420 MEDICAL PARK DRWatervliet, MI 49098-9237
Mailing Address420 Medical Park DrWatervliet, MI 49098-9237 · (269) 463-3600 · Fax (269) 463-5356
Phone(269) 463-3600
Fax(269) 463-5356
Sole ProprietorNo
Enumeration DateMay 16, 2006
Last NPPES UpdateSeptember 29, 2011
✔ NPI 1164474631 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MI · 5101009399
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.
Also ListedEmergency MedicineTaxonomy 207P00000X · License 5101009399 (MI)
420 MEDICAL PARK DR, Watervliet, MI 49098
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Other Identifiers 13

Other4155933-11MI · Medicaid - Pipp
Other3025952-11MI · Medicaid - Three Rivers
Medicare PINC96038064MI
Other93384289MI · Rr Medicare - Pipp
Medicare PIN0M90900006MI
OtherG56008112MI · Medicare - Three Rivers
Other5391075MI · Bcbs Ind Pin #
Medicaid11-4924242 COLOMAMI
OtherMK009399MI · Bcbs Ind Lic #
Medicare UPINB44597MI
Other93384289MI · Rr Medicare
Medicare PIN930084289MI
Medicaid11-5193581 HARTFORDMI

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 Michael Kelly's NPI number?

The NPI number for Michael Kelly is 1164474631. It was assigned to this individual provider in the NPPES registry on May 16, 2006.

Where is Michael Kelly located?

Michael Kelly practices at 420 Medical Park Dr, Watervliet, MI 49098. The listed phone number is (269) 463-3600.

What is Michael Kelly's specialty?

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

When was this NPI record last updated?

The NPPES record for Michael Kelly was last updated on September 29, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.