NPIMap

Individual provider Active NPI

Kelci Ann Stoltenberg

  • Family Nurse Practitioner
  • Sioux Falls, SD
National Provider Identifier
1215603865
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP002112 Issued in SD
Practice address
6100 S Louise Ave Ste 1100
Sioux Falls, SD 57108-6030
Phone
(605) 322-8630
NPI assigned
Aug 23, 2021
Last updated
Aug 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CP002112 SD Primary

Addresses

Primary practice location

6100 S Louise Ave Ste 1100
Sioux Falls, SD 57108-6030

Mailing address

6100 S Louise Ave Ste 1100
Sioux Falls, SD 57108-6030
Phone (605) 322-8630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210927000921 SD Practitioner - Nurse Practitioner 5991102477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1000 E 23Rd St
Sioux Falls, SD 57105-2122

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CP002112SDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Sep 5, 2021 Accepting new patients
Avera McKennan CurrentSince Sep 5, 2021 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan Past Accepting new patients

Locations

400 22nd Ave
Brookings, SD 57006
Phone (605) 692-6236

1000 E 23rd St
Ste 100
Sioux Falls, SD 57105
Phone (605) 322-1625

6100 S Louise Ave
Ste 1100
Sioux Falls, SD 57108
Phone (605) 322-8630

Interoperability endpoints

  • Direct secure messaging: kelci.stoltenberg@avera.sdhealthlink.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

  • Avera McKennan

    dba Avera McKennan Behavioral Health Clinic

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Sioux Falls, SD
    • NPI 1699009944
    Medicare reassignment Care Compare group NPD
  • Avera McKennan

    dba Avera Medical Group Oncology and Hematology Sioux Falls

    • Hematology & Oncology Physician
    • Sioux Falls, SD
    • NPI 1033185582
    NPD
  • Avera McKennan

    dba Avera Interventional Radiology

    • Diagnostic Radiology Physician
    • Sioux Falls, SD
    • NPI 1053680678
    NPD
  • Avera McKennan

    dba Avera Medical Group

    • Family Medicine Physician
    • Sioux Falls, SD
    • NPI 1376575514
    NPD (past)

Hospital & facility affiliations 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1215603865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 S LOUISE AVE STE 1100",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571086030",
            "telephone_number": "605-322-8630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 S LOUISE AVE STE 1100",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571086030",
            "telephone_number": "605-322-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLTENBERG",
        "first_name": "KELCI",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP002112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.