Active NPI
Jordann Hayley Kelly
- Licensed Practical Nurse
- Bellevue, NE
National Provider Identifier
1134834765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- P52989
- Practice address
- 2231 Lincoln Rd
Bellevue, NE 68005-3907 - Phone
- (402) 291-1203
- NPI assigned
- Jan 18, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | P52989 | IA | Primary |
Addresses
Primary practice location
2231 Lincoln Rd
Bellevue, NE 68005-3907
Mailing address
19809 Beverly Manor LN
Council Bluffs, IA 51503-5495
Phone (712) 326-1148
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P52989 | IA | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674000000000",
"number": "1134834765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19809 BEVERLY MANOR LN",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515035495",
"telephone_number": "712-326-1148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2231 LINCOLN RD",
"city": "BELLEVUE",
"state": "NE",
"postal_code": "680053907",
"telephone_number": "402-291-1203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "JORDANN",
"middle_name": "HAYLEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-18",
"last_updated": "2023-01-18",
"certification_date": "2023-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "IA",
"license": "P52989",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.