HOLLY R. KELLY N.P.
NPI 1750630786
Nurse Practitioner in Plymouth, IN

Q: What is Holly Kelly's NPI number?

The NPI number for Holly Kelly is 1750630786. It was assigned to this individual provider in the NPPES registry on September 6, 2012. The provider is also known as Holly R. Sucharetza.

Q: What is Holly Kelly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Holly Kelly was last updated on May 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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 September 06, 2012PECOS Enrolled

2855 MILLER DR STE 121B, PLYMOUTH, IN 46563(574) 522-0265(574) 406-0025 Get Directions Write a Review

NPPES record last updated: May 14, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Holly R. Kelly N.p. NPPES

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

HOLLY R. KELLY N.P. (NPI 1750630786) is an individual nurse practitioner in Plymouth, Indiana, licensed in Indiana (71004121A) and active in the NPI registry since September 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1750630786

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameHOLLY R. KELLYCredential: N.P.

Location Address2855 MILLER DR STE 121BPlymouth, IN 46563-8091

Mailing Address211 N Eddy StSouth Bend, IN 46617-2808 · (574) 237-9231 · Fax (574) 204-6355

Phone(574) 522-0265

Fax(574) 406-0025

Sole ProprietorNo

Enumeration DateSeptember 6, 2012

Last NPPES UpdateMay 14, 2026

NPPES CertifiedMay 14, 2026

✔ NPI 1750630786 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in IN · 71004121A

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

2855 MILLER DR STE 121B, Plymouth, IN 46563

Open in Google Maps ↗

Other Names 1

Former Name (1)Holly R. Sucharetza

Other Identifiers 1

Medicaid201092360IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.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)

Holly R. Kelly N.p. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46563 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

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

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.

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 Holly Kelly's NPI number?

The NPI number for Holly Kelly is 1750630786. It was assigned to this individual provider in the NPPES registry on September 6, 2012. The provider is also known as Holly R. Sucharetza.

Where is Holly Kelly located?

Holly Kelly practices at 2855 Miller Dr Ste 121B, Plymouth, IN 46563. The listed phone number is (574) 522-0265.

What is Holly Kelly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Holly Kelly enrolled in Medicare?

Yes. Holly Kelly is registered in the Medicare PECOS enrollment system.

What insurance does Holly Kelly accept?

Health plans from CareSource list Holly Kelly 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.

When was this NPI record last updated?

The NPPES record for Holly Kelly was last updated on May 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.