Individual provider Active NPI

Kelly J Anello, DC

  • Chiropractor
  • Waukesha, WI
National Provider Identifier
1104844430
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3919 Issued in WI
Practice address
557 W 29735 Saylesville Rd
Waukesha, WI 53189
Phone
(262) 287-0903
NPI assigned
Jul 17, 2006
Last updated
Aug 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3919-012 WI
Chiropractor 111N00000X 3919 WI Primary

Addresses

Primary practice location

557 W 29735 Saylesville Rd
Waukesha, WI 53189

Mailing address

PO Box 551
Mukwonago, WI 53149-0551
Phone (262) 354-4136

Other identifiers 1

IdentifierTypeStateIssuer
38947400MedicaidWI

Other names 1

  • Dr. Kelly J Wolf Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040427001238 WI Practitioner - Chiropractic 7113914607 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3919-012WIMDChiropractor
3919WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Kellys House Calls CurrentSince Jan 24, 2018 Accepting new patients
Mukwonago Chiropractic Centre, S.C. Chiropractor Past Accepting new patients
Wolf Family Chiropractic, LLC Chiropractor PastSince Dec 28, 2006 Accepting new patients
Allied Health of Wisconsin, SC Chiropractor Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1104844430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551",
            "city": "MUKWONAGO",
            "state": "WI",
            "postal_code": "531490551",
            "telephone_number": "262-354-4136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 W 29735 SAYLESVILLE RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "53189",
            "telephone_number": "262-287-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANELLO",
        "first_name": "KELLY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3919-012",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38947400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "WOLF",
            "middle_name": "J",
            "prefix": "DR.",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.