Individual provider Active NPI

Debbie L Kelley, AU D

  • Audiologist
  • Sedona, AZ
National Provider Identifier
1013136753
Registry record updated Sep 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
DA1429 Issued in AZ
Practice address
61 Bell Rock PLZ
Ste B
Sedona, AZ 86351-8810
Phone
(928) 284-2116
Fax
(928) 496-2122
NPI assigned
Apr 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X DA1429 AZ Primary

Addresses

Primary practice location

61 Bell Rock PLZ
Ste B
Sedona, AZ 86351-8810

Mailing address

39506 N Daisy Mountain Dr
Suite 122-624
Anthem, AZ 85086-1663
Phone (928) 284-2116

Other identifiers 3

IdentifierTypeStateIssuer
1013136753OtherAZINDIVIDUAL NPI
1528487014OtherAZGROUP NPI
Z164325OtherAZPTAN

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)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441670400000",
    "number": "1013136753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39506 N DAISY MOUNTAIN DR",
            "address_2": "SUITE 122-624",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850861663",
            "telephone_number": "928-284-2116",
            "fax_number": "928-496-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 BELL ROCK PLZ",
            "address_2": "STE B",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863518810",
            "telephone_number": "928-284-2116",
            "fax_number": "928-496-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "DEBBIE",
        "middle_name": "L",
        "credential": "AU D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2015-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AZ",
            "license": "DA1429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1013136753",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1528487014",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "Z164325",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedona, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.