Individual provider Active NPI

Kelly Earle, DNP, APRN, FNC-C

  • Family Nurse Practitioner
  • Bozeman, MT
National Provider Identifier
1104410745
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NUR-APRN-LIC-165997 Issued in MT
Practice address
935 Highland Blvd Ste 2180
Bozeman, MT 59715-6904
Phone
(406) 414-5512
NPI assigned
Feb 24, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NUR-APRN-LIC-165997 MT Primary

Addresses

Primary practice location

935 Highland Blvd Ste 2180
Bozeman, MT 59715-6904

Mailing address

915 Highland Blvd
Bozeman, MT 59715-6902
Phone (406) 414-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210315001552 MT Practitioner - Nurse Practitioner 6305252420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bozeman Health Deaconess HospitalGroup PAC ID 4688984164, 309 clinicians

Practice addresses (Care Compare)

935 Highland Blvd
Suite 2180
Bozeman, MT 59715-6904
Phone (406) 414-5512

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.04 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
72.66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NUR-APRN-LIC-165997MTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bozeman Health Deaconess Hospital CurrentSince May 3, 2021 Accepting new patients
Bozeman Health Deaconess Hospital CurrentSince May 3, 2021 Accepting new patients
Belgrade Clinic PLLP Current Accepting new patients
Bozeman Health Deaconess Hospital Past Accepting new patients

Locations

925 Highland Blvd
Bozeman, MT 59715
Phone (406) 414-3780

931 Highland Blvd
Ste 3350
Bozeman, MT 59715
Phone (406) 414-5331

935 Highland Blvd
Ste 2180
Bozeman, MT 59715
Phone (406) 414-5331

925 Highland Blvd
Ste 1220
Bozeman, MT 59715
Phone (406) 414-3780

915 Highland Blvd
Bozeman, MT 59715
Phone (406) 414-1720

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1614124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1104410745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 HIGHLAND BLVD",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156902",
            "telephone_number": "406-414-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 HIGHLAND BLVD STE 2180",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156904",
            "telephone_number": "406-414-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARLE",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, FNC-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-24",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "NUR-APRN-LIC-165997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

Verify at the official NPI Registry.