What is Mick Kelly's NPI number?

Mick Kelly's National Provider Identifier (NPI) is 1053240507, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.

What is Mick Kelly's specialty?

Mick Kelly is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program (Student, Health Care).

Where is Mick Kelly located?

Mick Kelly's practice location on file with NPPES is 2500 N State St, Jackson, MS 39216-4505.

What is Mick Kelly's phone number?

The practice phone number listed in the NPPES registry for Mick Kelly is (601) 508-1170.

Is Mick Kelly's NPI active?

Yes — Mick Kelly's NPI (1053240507) is active in the NPPES registry as of the last update on 2026-05-19.

IndividualActive

Mick Kelly

NPI 1053240507 · Student in an Organized Health Care Education/Training Program · Jackson, MS

Mick Kelly is a Student in an Organized Health Care Education/Training Program provider in Jackson, MS (NPI 1053240507).

Provider details

NPI number: 1053240507
Entity type: Individual
Primary specialty: Student in an Organized Health Care Education/Training ProgramStudent, Health Care
Sex: Male
Sole proprietor: No

Specialties & taxonomies

Student in an Organized Health Care Education/Training ProgramPrimary390200000X
Student, Health Care

Profile Score

Basic profile(46/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure38% of score
Under 1 yr in registry
Profile completeness38% of score
83% of core fields populated
Practice footprint23% of score
1 documented practice location

Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

Practice location

2500 N State St

Jackson, MS 39216-4505

Phone: (601) 508-1170

Street-level locationGet directions

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Mailing address