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Timothy Kelly

Case Manager/Care Coordinator β€’ Independence, OH

Active NPI 1083188643 Individual Practitioner Male Practitioner
Practice location in NPPES

6200 Rockside Woods Blvd N Ste 305
Independence, OH 441312343

Call 2344105775 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

6200 Rockside Woods Blvd N Ste 305

Independence, OH 441312343

Telephone 2344105775
Organization at the Same NPPES Address or Phone
Ohio Mentor, Inc. Facility NPI 1861568990

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2019

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Independence and Ohio

130 active clinicians are listed under Case Manager/Care Coordinator with a practice address in Independence, OH (35,328 in Ohio).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Independence

0% of these 130 clinicians have the CMS telehealth indicator.

0% of these 130 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-08-08
Case Manager/Care Coordinator Primary Specialty

NUCC Taxonomy Code: 171M00000X

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

License # reported to NPPES OH CDCA.183151
Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

Social Worker

NUCC Taxonomy Code: 104100000X

License # reported to NPPES OH S.2202740-TRNE

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Peer Specialist

NUCC Taxonomy Code: 175T00000X

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: State Medical Board of Ohio.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

15 Historical Events
πŸ“
Updated Practice Location August 08, 2024

Registered at 6200 ROCKSIDE WOODS BLVD N STE 305, INDEPENDENCE, OH 441312343 (Tel: 2344105775)

πŸ“
Updated Business Mailing Address August 08, 2024

Registered at 21231 WILMORE AVE, EUCLID, OH 441232823 (Tel: 2344105775)

πŸ“
Updated Practice Location April 19, 2024

Registered at 8411 BROADWAY AVE STE 3932, CLEVELAND, OH 441053932 (Tel: 2164410200)

πŸ“
Updated Business Mailing Address April 19, 2024

Registered at 8411 BROADWAY AVE STE 3932, CLEVELAND, OH 441053932 (Tel: 2164410200)

πŸ“
Updated Practice Location February 22, 2023

Registered at 1744 PAYNE AVE, CLEVELAND, OH 441142910 (Tel: 2166236555)

πŸ“
Updated Business Mailing Address February 22, 2023

Registered at 1744 PAYNE AVE, CLEVELAND, OH 441142910 (Tel: 2166236555)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 22, 2023

Counselor (license number reported to NPPES: OH CDCA.183151)

πŸ“
Updated Practice Location March 15, 2022

Registered at 7232 JUSTIN WAY, MENTOR, OH 440604881 (Tel: 4405788200)

πŸ“
Updated Business Mailing Address March 15, 2022

Registered at 7232 JUSTIN WAY, MENTOR, OH 440604881 (Tel: 4405788200)

βœ…
NPI Profile Active January 31, 2019

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) January 31, 2019

Registered at 1563 EAST BLVD, CLEVELAND, OH 441061720 (Tel: 3308099503)

πŸ“
Business Mailing Address (Initial Record) January 31, 2019

Registered at 1563 EAST BLVD, CLEVELAND, OH 441061720 (Tel: 3308099503)

πŸ‘€
Provider Name / Credentials (Initial Record) January 31, 2019

Recorded as TIMOTHY KELLY

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 31, 2019

Peer Specialist

🟒
Initial NPI Registration & Enumeration January 17, 2019

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1083188643
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 17, 2019
Last Update: August 08, 2024
Sole Proprietor: Yes

Mailing Address

21231 Wilmore Ave

Euclid, OH 441232823

Phone: 2344105775

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.