Active NPI
Kelly O'Neill, M.A.ED.; CWCII
- Case Manager/Care Coordinator
- Mammoth Lakes, CA
National Provider Identifier
1003777814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- B1396473F4
- Practice address
- 461 Sierra Park Rd
Mammoth Lakes, CA 93546-2076 - Phone
- (805) 216-2868
- NPI assigned
- Nov 20, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | B1396473F4 | CA | Primary |
Addresses
Primary practice location
461 Sierra Park Rd
Mammoth Lakes, CA 93546-2076
Mailing address
PO Box 9094
Mammoth Lakes, CA 93546-9041
Phone (805) 216-2868
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| B1396473F4 | CA | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1763596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763596800000",
"number": "1003777814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9094",
"city": "MAMMOTH LAKES",
"state": "CA",
"postal_code": "935469041",
"telephone_number": "805-216-2868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "461 SIERRA PARK RD",
"city": "MAMMOTH LAKES",
"state": "CA",
"postal_code": "935462076",
"telephone_number": "805-216-2868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'NEILL",
"first_name": "KELLY",
"credential": "M.A.ED.; CWCII",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-11-20",
"last_updated": "2025-11-20",
"certification_date": "2025-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "CA",
"license": "B1396473F4",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mammoth Lakes, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.