JOHN JOSEPH KELLY IV MD
NPI 1174150163
Orthopaedic Surgery - Sports Medicine in Rochester, MN

NPI Status: Active since March 27, 2020

Contact Information

200 1ST ST SW
ROCHESTER, MN
ZIP 55905
Phone: (507) 284-2511

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  • Individual
  • Male
  • Orthopaedic Surgery
  • Sports Medicine

About JOHN KELLY

This page provides the complete NPI Profile along with additional information for John Kelly, a provider established in Rochester, Minnesota with a medical specialization in Orthopaedic Surgery, focusing in sports medicine . The healthcare provider is registered in the NPI registry with number 1174150163 assigned on March 2020. The practitioner's primary taxonomy code is 207XX0005X with license number 79276 (MN). The provider is registered as an individual and his NPI record was last updated August 2025.

NPI
1174150163
Provider Name
JOHN JOSEPH KELLY IV MD
Gender
Male
Entity Type
Individual
Location Address
200 1ST ST SW ROCHESTER, MN 55905
Location Phone
(507) 284-2511
Mailing Address
PO BOX 860912 MINNEAPOLIS, MN 55486
Mailing Phone
(507) 284-2511
Is Sole Proprietor?
No
Enumeration Date
03-27-2020
Last Update Date
08-01-2025
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Location Map

Secondary Locations

  • 1222 S. Orange Avenue 5th FL, MP#43
    Orlando, FL 32806
    (321) 841-1764

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Orthopaedic Surgery Sports Medicine

Taxonomy Code
207XX0005X
Type
Allopathic & Osteopathic Physicians
License No.
79276
License State
MN
Taxonomy Description
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1174150163
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
21144250112
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 1 + 4 + 4 + 2 + 5 + 0 + 1 + 1 + 2 + 24 = 47
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 47 = 33

The NPI number 1174150163 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

CHRISTINE MARIA MILLER MD, PHD

Radiology

(Diagnostic Radiology)

200 1ST ST SW
ROCHESTER, MN
ZIP 55905

(507) 284-2511

DR. EMIL D. KORETZKY MD

Dermatology

200 1ST ST SW
ROCHESTER, MN
ZIP 55905

(507) 284-2511

GLADYS A RADKE PAC

Physician Assistant

200 1ST ST SW
ROCHESTER, MN
ZIP 55905

(507) 284-2511

MRS. KILEY JO JOHNSON M.S.

Genetic Counselor, MS

200 1ST ST SW
ROCHESTER, MN
ZIP 55905

(507) 266-3317

LISA K BUSS PHARM.D.

Pharmacist

200 1ST ST SW
ROCHESTER, MN
ZIP 55905

(507) 284-1094

DAVID R DAUGHERTY M.D.

Psychiatry & Neurology

(Psychiatry)

200 1ST ST SW
ROCHESTER, MN
ZIP 55905

(507) 284-2511

RENATO D ALARCON M.D.

Psychiatry & Neurology

(Psychiatry)

200 1ST ST SW
ROCHESTER, MN
ZIP 55905

(507) 284-2511

TANYA MARIE CADDELL R.PH.

Pharmacist

200 1ST ST SW
ROCHESTER, MN
ZIP 55905

(507) 284-2511

MIGUEL E CABANELA M.D.

Orthopaedic Surgery

(Adult Reconstructive Orthopaedic Surgery)

200 1ST ST SW
ROCHESTER, MN
ZIP 55905

(507) 284-2511

RONALD J FAUST M.D.

Anesthesiology

200 1ST ST SW
ROCHESTER, MN
ZIP 55905

(507) 284-2511

MICHAEL A FARRELL M.D.

Radiology

(Diagnostic Radiology)

200 1ST ST SW
ROCHESTER, MN
ZIP 55905

(507) 284-2511

JAMES N INGLE M.D.

Internal Medicine

(Medical Oncology)

200 1ST ST SW
ROCHESTER, MN
ZIP 55905

(507) 284-2511

ROSALINA L ABBOUD M.D.

Obstetrics & Gynecology

(Gynecology)

200 1ST ST SW
ROCHESTER, MN
ZIP 55905

(507) 284-2511

DAVID R FARLEY M.D.

Surgery

200 1ST ST SW
ROCHESTER, MN
ZIP 55905

(507) 284-2511

PAUL F MCGOUGH M.D.

Radiology

(Diagnostic Radiology)

200 1ST ST SW
ROCHESTER, MN
ZIP 55905

(507) 284-2511

DANIEL J BLUM M.D.

Otolaryngology

200 1ST ST SW
ROCHESTER, MN
ZIP 55905

(507) 284-2511

JOHN B COLLINS M.D.

Family Medicine

200 1ST ST SW
ROCHESTER, MN
ZIP 55905

(507) 284-2511

TENG JI M.D.

Pediatrics

200 1ST ST SW
ROCHESTER, MN
ZIP 55905

(507) 284-2511

IAN P CLEMENTS M.D.

Internal Medicine

(Cardiovascular Disease)

200 1ST ST SW
ROCHESTER, MN
ZIP 55905

(507) 284-2511

JODI ANN COOK PH. D.

Audiologist

200 1ST ST SW
ROCHESTER, MN
ZIP 55905

(507) 284-2511

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1174150163, enumerated as an "individual" on March 27, 2020.

The provider is located at 200 1ST ST SW ROCHESTER, MN 55905 and the phone number is (507) 284-2511.

Orthopaedic Surgery with taxonomy code 207XX0005X and a focus in Sports Medicine.