Individual provider Active NPI

Heather Ann Robrecht Kelly, ARNP

  • Acute Care Nurse Practitioner
  • Citrus Heights, CA
National Provider Identifier
1124264239
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
21780 Issued in CA
Practice address
7115 Greenback LN
FL 2
Citrus Heights, CA 95621-6133
Phone
(916) 733-3460
Fax
(916) 560-0266
NPI assigned
Dec 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 21780 CA
Acute Care Nurse Practitioner 363LA2100X 21780 CA Primary

Addresses

Primary practice location

7115 Greenback LN
FL 2
Citrus Heights, CA 95621-6133

Mailing address

3400 Data Dr
Attn: Credentialing/Payer Enrollment
Rancho Cordova, CA 95670-7956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20130718000330 CA Practitioner - Nurse Practitioner 9537300447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

7115 Greenback LN
FL 2
Citrus Heights, CA 95621-6133
Phone (916) 733-3333

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21780CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince May 15, 2023 Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients
Dignity Community Care Past Accepting new patients

Locations

7115 Greenback Ln
Fl 2
Citrus Heights, CA 95621
Phone (916) 536-3620

2330 W Covell Blvd
Davis, CA 95616
Phone (530) 668-2600

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

3000 Q St
Sacramento, CA 95816
Phone (916) 733-5701

632 W Gibson Rd
Woodland, CA 95695
Phone (530) 666-1631

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1124264239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "address_2": "ATTN: CREDENTIALING/PAYER ENROLLMENT",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7115 GREENBACK LN",
            "address_2": "FL 2",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956216133",
            "telephone_number": "916-733-3460",
            "fax_number": "916-560-0266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "HEATHER",
        "middle_name": "ANN ROBRECHT",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-18",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "21780",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "21780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Citrus Heights, CA

Sources for this page

Verify at the official NPI Registry.