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MR. TYLER KELLY
NPI 1760159271
Military Health Care Provider - Independent Duty Corpsman in San Diego, CA

Active since August 24, 2021
34101 FARENHOLT AVE BLDG 14, SAN DIEGO, CA 92134(937) 621-3743 Get Directions Write a Review

NPPES record last updated: January 20, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 20, 2022, Aug 24, 2021 (2 updates tracked since 2021).

About Mr. Tyler Kelly NPPES

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

MR. TYLER KELLY (NPI 1760159271) is an individual independent duty corpsman provider in San Diego, California and active in the NPI registry since August 2021.

NPPES Registry Identity

NPI1760159271
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameMR. TYLER KELLY
Location Address34101 FARENHOLT AVE BLDG 14San Diego, CA 92134-7000
Mailing Address10265 Waldron WaySan Diego, CA 92124-3218
Phone(937) 621-3743
Sole ProprietorNo
Enumeration DateAugust 24, 2021
Last NPPES UpdateJanuary 20, 20222 updates tracked since enumeration
NPPES CertifiedJanuary 20, 2022
✔ NPI 1760159271 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers
Taxonomy Code1710I1002X
Definition
A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
34101 FARENHOLT AVE BLDG 14, San Diego, CA 92134
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Other Providers at the Same Location NPPES 20

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

MR. MICHAEL WILLIAM ASHLINE IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-6195
MR. ROBERT LUND IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (864) 201-6478
JOHN DAVID MACLEOD
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (716) 955-9805
STEVEN LE IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-7968
WILLIAM ALLEN IRISH IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
APO, AP 92134
San Diego County (619) 532-6195
TIMOTHY JOHN RUANE IDC
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-7968
OLIVIA KROHTA
Student in an Organized Health Care Education/Training Program
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-7968
JARED MICHAEL O'BRIEN
Military Health Care Provider (Independent Duty Corpsman)
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134
San Diego County (619) 532-7968

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 Tyler Kelly's NPI number?

The NPI number for Tyler Kelly is 1760159271. It was assigned to this individual provider in the NPPES registry on August 24, 2021.

Where is Tyler Kelly located?

Tyler Kelly practices at 34101 Farenholt Ave Bldg 14, San Diego, CA 92134. The listed phone number is (937) 621-3743.

What is Tyler Kelly's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Tyler Kelly was last updated on January 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.