Kelly D Carriger
Individual provider Active NPI Contractor · Bellevue, NE
NPI 1124833058 · NPPES record last updated Feb 10, 2025
Key facts
- NPI
- 1124833058
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 3747P1801X (NE)
- Practice address
- 12103 S 29TH St
Bellevue, NE 68123-1404 - Phone
- (626) 672-8587
- NPI assigned
- Feb 10, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3747P1801X | NE | MD | Personal Care Attendant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 3747P1801X | NE | |
| Contractor | 171W00000X | 3747P1801X | NE | Yes |
Addresses
Primary practice location
12103 S 29TH St
Bellevue, NE 68123-1404
Mailing address
12103 S 29TH St
Bellevue, NE 68123-1404
Phone (626) 672-8587
Other providers in Bellevue, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.