Latreca Marie Kelley, CMA/CNA

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

05352 Issued in KS

Practice address

4438 E Falcon St
Wichita, KS 67220-1776

Phone

(316) 347-6633

NPI assigned

Feb 15, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Latreca Marie Marks Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Medical Assistant

State licenses

Practice roles

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.

• Therapeutic Time, LLC

  • Home Health Agency
  • Wichita, KS
  • NPI 1386086171
  NPD (past) Authorized official

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

{
    "created_epoch": "1360886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360886400000",
    "number": "1174863898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20803",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672086803",
            "telephone_number": "316-347-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4438 E FALCON ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672201776",
            "telephone_number": "316-347-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "LATRECA",
        "middle_name": "MARIE",
        "credential": "CMA/CNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-15",
        "last_updated": "2013-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "KS",
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "KS",
            "license": "05352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LATRECA",
            "last_name": "MARKS",
            "middle_name": "MARIE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Tara Keller
• Rickey D Kellerman, M.D.
• Bret Kelley, D.C.
• Caleb Kelley
• Jill E Kelley, PTA
• Paige Kelley
• Sandra J Kelliher, LMFT
• Mia Kells, LMFT-T
• Danielle Kelly, PA-C
• Donna Marie Kelly

• Nurse's Aide in Wichita, KS
• Providers in Wichita, KS by specialty
• Nurse's Aide in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.