Individual provider Active NPI

Beth Marie Kelsey, NP

  • Women's Health Nurse Practitioner
  • Muncie, IN
National Provider Identifier
1215964135
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
28074206A Issued in IN
Practice address
School of Nursing
Ball State University
Muncie, IN 47306-0265
Phone
(765) 285-5761
Fax
(765) 285-2169
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 171676 CO
Women's Health Nurse Practitioner 363LW0102X 28074206A IN Primary

Addresses

Primary practice location

School of Nursing
Ball State University
Muncie, IN 47306-0265

Mailing address

3856 Elston Hockstock Rd
Batavia, OH 45103-3322
Phone (513) 724-1035

Other identifiers 1

IdentifierTypeStateIssuer
76135250MedicaidCO

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
171676COMDWomen's Health Nurse Practitioner
28074206AINMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215964135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3856 ELSTON HOCKSTOCK RD",
            "city": "BATAVIA",
            "state": "OH",
            "postal_code": "451033322",
            "telephone_number": "513-724-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SCHOOL OF NURSING",
            "address_2": "BALL STATE UNIVERSITY",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473060265",
            "telephone_number": "765-285-5761",
            "fax_number": "765-285-2169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSEY",
        "first_name": "BETH",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CO",
            "license": "171676",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IN",
            "license": "28074206A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "76135250",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.