Active NPI
Charlotte Kelley & Associates PC
- Nurse Practitioner
- Des Moines, IA
National Provider Identifier
1104870674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- J059522
- Legal business name
- CHARLOTTE KELLEY & ASSOCIATES PC
- Practice address
- 2600 Grand Ave
Suite 125
Des Moines, IA 50312-5375 - Phone
- (515) 277-3400
- Fax
- (515) 277-9036
- NPI assigned
- May 20, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Charlotte M. Kelley, ARNP
- Title
- President and Ceo
- Phone
- (515) 277-3400
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | J059522 | IA | Primary |
| Gerontology Nurse Practitioner | 363LG0600X | J059522 | IA |
Addresses
Primary practice location
2600 Grand Ave
Suite 125
Des Moines, IA 50312-5375
Mailing address
2213 Grand Ave
Des Moines, IA 50312-5305
Phone (515) 237-3974
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0420489 | Medicaid | IA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1200614400000",
"number": "1104870674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2213 GRAND AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503125305",
"telephone_number": "515-237-3974",
"fax_number": "515-883-2692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 GRAND AVE",
"address_2": "SUITE 125",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503125375",
"telephone_number": "515-277-3400",
"fax_number": "515-277-9036"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHARLOTTE KELLEY & ASSOCIATES PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-20",
"last_updated": "2008-01-18",
"status": "A",
"authorized_official_last_name": "KELLEY",
"authorized_official_first_name": "CHARLOTTE",
"authorized_official_middle_name": "M.",
"authorized_official_title_or_position": "PRESIDENT AND CEO",
"authorized_official_telephone_number": "515-277-3400",
"authorized_official_credential": "ARNP"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": "IA",
"license": "J059522",
"primary": true
},
{
"code": "363LG0600X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Gerontology",
"state": "IA",
"license": "J059522",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0420489",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.