Kelli M Ward, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

3425 Issued in AZ

Practice address

2090 Smoketree Ave N
Lake Havasu City, AZ 86403-5806

Phone

(928) 854-1800

Fax

(928) 854-1847

NPI assigned

Jun 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Lakeview Family Health Care

  • Family Medicine Physician
  • Lake Havasu City, AZ
  • NPI 1053582627
  NPD (past) Authorized official

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274140800000",
    "number": "1104867308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3630",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860033630",
            "telephone_number": "928-213-6100",
            "fax_number": "928-774-6687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 SMOKETREE AVE N",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035806",
            "telephone_number": "928-854-1800",
            "fax_number": "928-854-1847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "KELLI",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2010-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "3425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470724",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Kimberly Walker
• Matthew Wallender, PTA
• Walmart Inc.
• Sandy Walters, RN
• Shannon Ward, LPN
• David Carling Watts, D.O
• Kaitlyn Weber, RN
• Weiss Pediatrics PLLC
• Paige Weisz, APRN

• Family Medicine Physician in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2010; 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.