Individual provider Active NPI

Kelly Lynn Welsh, RDN

  • Renal Nutrition Registered Dietitian
  • Cedarburg, WI
National Provider Identifier
1023649647
Registry record updated Feb 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Renal Nutrition Registered DietitianTaxonomy code 133VN1005X
License
849785 Issued in WI
Practice address
175 Sunset LN
Cedarburg, WI 53012-2616
Phone
(414) 732-9352
NPI assigned
Feb 2, 2020
Last updated
Feb 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Renal Nutrition Registered Dietitian 133VN1005X 849785 WI Primary

Addresses

Primary practice location

175 Sunset LN
Cedarburg, WI 53012-2616

Mailing address

175 Sunset LN
Cedarburg, WI 53012-2616
Phone (414) 732-9352

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

LicenseStateTypeSpecialty
849785WIMDRenal Nutrition Registered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1580601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580601600000",
    "number": "1023649647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 SUNSET LN",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122616",
            "telephone_number": "414-732-9352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 SUNSET LN",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122616",
            "telephone_number": "414-732-9352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELSH",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-02",
        "last_updated": "2020-02-02",
        "certification_date": "2020-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "WI",
            "license": "849785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2020; 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.