Autumn Rose Kelly, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

002148 Issued in IA

Practice address

3 S 4TH Ave
Food and Nutrition Services
Marshalltown, IA 50158-2924

Phone

(641) 754-5271

NPI assigned

Nov 12, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, GA, TN, KY4 enrollments

Enrollment records 4

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Hoover, AL
  • NPI 1538686498

  FL, GA, KY, TN

  Medicare reassignment

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

{
    "created_epoch": "1415750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415750400000",
    "number": "1205232634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23767 667TH AVE",
            "city": "NEVADA",
            "state": "IA",
            "postal_code": "502017616",
            "telephone_number": "319-480-5574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 S 4TH AVE",
            "address_2": "FOOD AND NUTRITION SERVICES",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501582924",
            "telephone_number": "641-754-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "AUTUMN",
        "middle_name": "ROSE",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-12",
        "last_updated": "2014-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IA",
            "license": "002148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Addyson Kane
• Paul Kang, DDS
• Daun Rae Keefe, LISW
• Karolyn Kellen
• Ryan Keller, MFT
• James Khile, TLMFT
• Kimball and Beecher Marshalltown PLLC
• Leanne K. Knoop, PA-C
• Michael Eugene Knutsen, MPAS, PA-C
• Kathryn Koshinski, OT

• Registered Dietitian in Marshalltown, IA
• Providers in Marshalltown, IA by specialty
• Registered Dietitian in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; 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.