Individual provider Active NPI

Amanda Kelsey, DC

  • Chiropractor
  • Oakdale, MN
National Provider Identifier
1164405973
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4259 Issued in MN
Practice address
5705 Hadley Avenue
Oakdale, MN 55128-1022
Phone
(651) 538-4558
Fax
(866) 496-4047
NPI assigned
Nov 25, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4259 MN Primary

Addresses

Primary practice location

5705 Hadley Avenue
Oakdale, MN 55128-1022

Mailing address

5705 Hadley Avenue
Oakdale, MN 55128-1022
Phone (651) 538-4558

Other identifiers 3

IdentifierTypeStateIssuer
100961OtherMNHEALTH PARTNERS
56M14KEOtherMNBCBS
318655500MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070214000131 MN Practitioner - Chiropractic 3577565951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5705 Hadley Ave N
Oakdale, MN 55128-1022
Phone (651) 538-4558

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey Chiropractic, PLLC Chiropractor CurrentSince Aug 1, 2002 Accepting new patients
Schenk Chiropractic, PA Chiropractor Past Accepting new patients

Locations

2599 White Bear Ave N
Saint Paul, MN 55109
Phone (651) 770-3891

5705 Hadley Ave N
Saint Paul, MN 55128
Phone (651) 538-4558

Organizations & group practices 2

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": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1164405973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5705 HADLEY AVENUE",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551281022",
            "telephone_number": "651-538-4558",
            "fax_number": "866-496-4047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5705 HADLEY AVENUE",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551281022",
            "telephone_number": "651-538-4558",
            "fax_number": "866-496-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSEY",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-25",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "100961",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "56M14KE",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "318655500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakdale, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.