Active NPI
Sukeshini P Kelly, RN
- Maternal Newborn Registered Nurse
- Colton, CA
National Provider Identifier
1063610590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Maternal Newborn Registered Nurse
- License
- 482520
- Practice address
- 2033 E Colunga St
Colton, CA 92324-7510 - Phone
- (909) 872-1113
- Fax
- (909) 872-1113
- NPI assigned
- Jul 5, 2007
- Last updated
- Sep 11, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 9
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 482520 | CA | |
| Case Management Registered Nurse | 163WC0400X | 482520 | CA | |
| Cardiac Rehabilitation Registered Nurse | 163WC3500X | 482520 | CA | |
| Emergency Registered Nurse | 163WE0003X | 482520 | CA | |
| Maternal Newborn Registered Nurse | 163WM0102X | 482520 | CA | Primary |
| Neonatal Intensive Care Registered Nurse | 163WN0002X | 482520 | CA | |
| Urology Registered Nurse | 163WU0100X | 482520 | CA | |
| Wound Care Registered Nurse | 163WW0000X | 482520 | CA | |
| Ostomy Care Registered Nurse | 163WX1500X | 482520 | CA |
Addresses
Primary practice location
2033 E Colunga St
Colton, CA 92324-7510
Mailing address
2033 E Colunga St
Colton, CA 92324-7510
Phone (909) 872-1113
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| EPS016950 | Medicaid | CA | |
| RVN005060 | Medicaid | CA |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 482520 | CA | MD | Urology Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1063610590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2033 E COLUNGA ST",
"city": "COLTON",
"state": "CA",
"postal_code": "923247510",
"telephone_number": "909-872-1113",
"fax_number": "909-872-1113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2033 E COLUNGA ST",
"city": "COLTON",
"state": "CA",
"postal_code": "923247510",
"telephone_number": "909-872-1113",
"fax_number": "909-872-1113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "SUKESHINI",
"middle_name": "P",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-05",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "CA",
"license": "482520",
"primary": false
},
{
"code": "163WC0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Case Management",
"state": "CA",
"license": "482520",
"primary": false
},
{
"code": "163WC3500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Cardiac Rehabilitation",
"state": "CA",
"license": "482520",
"primary": false
},
{
"code": "163WE0003X",
"taxonomy_group": "",
"desc": "Registered Nurse, Emergency",
"state": "CA",
"license": "482520",
"primary": false
},
{
"code": "163WM0102X",
"taxonomy_group": "",
"desc": "Registered Nurse, Maternal Newborn",
"state": "CA",
"license": "482520",
"primary": true
},
{
"code": "163WN0002X",
"taxonomy_group": "",
"desc": "Registered Nurse, Neonatal Intensive Care",
"state": "CA",
"license": "482520",
"primary": false
},
{
"code": "163WU0100X",
"taxonomy_group": "",
"desc": "Registered Nurse, Urology",
"state": "CA",
"license": "482520",
"primary": false
},
{
"code": "163WW0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Wound Care",
"state": "CA",
"license": "482520",
"primary": false
},
{
"code": "163WX1500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Ostomy Care",
"state": "CA",
"license": "482520",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "EPS016950",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "RVN005060",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Colton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.