Provider Demographics
NPI:1689675266
Name:ONEY, KELLY A (CNS)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:A
Last Name:ONEY
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:A
Other - Last Name:SARVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1425 EAGLE RIDGE DR.
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375
Mailing Address - Country:US
Mailing Address - Phone:219-213-2315
Mailing Address - Fax:219-213-2932
Practice Address - Street 1:MOTUS INTEGRATIVE HEALTH, PC
Practice Address - Street 2:1425 EAGLE RIDGE DR.
Practice Address - City:SCHEREVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375
Practice Address - Country:US
Practice Address - Phone:219-213-2315
Practice Address - Fax:219-213-2932
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28115734A363LF0000X, 364SW0102X
IN70000075A363LF0000X, 364SW0102X
IN70000075B363L00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
INM400076006Medicare PIN