OrganizationActive
St Joseph Primary LLC
NPI 1104866136 · Family Medicine Physician · Kokomo, IN
Provider details
- NPI number
- 1104866136
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Andrew Kellar, Regional Practice Manager(765) 457-8381
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% 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
3109 W Sycamore St
Kokomo, IN 46901-4026
Phone: (765) 457-8381
Fax: (765) 457-4443
Street-level locationGet directions
Mailing address
3109 W Sycamore St
Kokomo, IN 46901-4026
Other names (DBA / former)
- Doing business as
- Sycamore Primary Care
Registry dates
- Enumerated
- 2006-06-07
- Last updated
- 2007-10-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.