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JODY L. KELLY M.D. & ASSOCIATES, LLC - NORTH
NPI 1881610475
Specialist in Peoria, IL

Active since July 15, 2006CLIA 14D0989753 · Waiver
5401 N. KNOXVILLE AVE., SUITE 300, PEORIA, IL 61614(309) 692-4702(309) 692-0746 Get Directions Write a Review

NPPES record last updated: December 20, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jody L. Kelly M.d. & Associates, Llc - North NPPES

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

JODY L. KELLY M.D. & ASSOCIATES, LLC - NORTH (NPI 1881610475) is a healthcare organization registered as a specialist in Peoria, Illinois and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through April 30, 2028 and lists Suzette M. Long, Billing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1881610475
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameJODY L. KELLY M.D. & ASSOCIATES, LLC
Location Address5401 N. KNOXVILLE AVE., SUITE 300Peoria, IL 61614-5021
Mailing Address2901 N. Knoxville Ave.Peoria, IL 61603-1747 · (309) 688-7010 · Fax (309) 688-7044
Phone(309) 692-4702
Fax(309) 692-0746
Organization SubpartNo
Authorized OfficialSuzette M. LongBilling Coordinator · (309) 688-7082
Enumeration DateJuly 15, 2006
Last NPPES UpdateDecember 20, 2011
✔ NPI 1881610475 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
5401 N. KNOXVILLE AVE., Peoria, IL 61614
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Other Names 1

Doing Business AsJody L. Kelly M.d. & Associates, Llc - North

Other Identifiers 1

Medicare UPIN209281IL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0989753

Jody L Kelly MD & Associates LLC · Peoria, IL
Active · expires Apr 30, 2028
CLIA Number14D0989753
Laboratory TypePhysician Office
Certificate Effective DateMay 1, 2026
Certificate Expiration DateApril 30, 2028
Laboratory DirectorJody L. Kelly
Laboratory Phone(309) 688-7010
Laboratory LocationJody L Kelly MD & Associates LLC2901 N Knoxville Ave, Peoria, IL 61603
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Jody L. Kelly M.D. & Associates, LLC's NPI number?

The NPI number for Jody L. Kelly M.D. & Associates, LLC is 1881610475. It was assigned to this organization in the NPPES registry on July 15, 2006. The provider is doing business as Jody L. Kelly M.D. & Associates, LLC - North.

Where is Jody L. Kelly M.D. & Associates, LLC located?

Jody L. Kelly M.D. & Associates, LLC is located at 5401 N. Knoxville Ave. Suite 300, Peoria, IL 61614. The listed phone number is (309) 692-4702.

What is Jody L. Kelly M.D. & Associates, LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Jody L. Kelly M.D. & Associates, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0989753) is associated with this NPI, valid through April 30, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jody L. Kelly M.D. & Associates, LLC was last updated on December 20, 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.