Individual provider Active NPI

Kaleigh Rebecca Nelles, MD

  • Psychiatry Physician
  • Maple Grove, MN
National Provider Identifier
1245977198
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
83442 Issued in MN
Practice address
13603 80TH Cir N
Maple Grove, MN 55369-8961
Phone
(763) 274-3120
Fax
(763) 274-3121
NPI assigned
May 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 83442 MN Primary

Addresses

Primary practice location

13603 80TH Cir N
Maple Grove, MN 55369-8961

Mailing address

1900 Silver Lake Rd NW
New Brighton, MN 55112-1786
Phone (763) 274-3120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Family Support Services Inc. CurrentSince Sep 14, 2026 Accepting new patients

Locations

13603 80th Cir N
Maple Grove, MN 55369
Phone (763) 274-3120

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

Organizations & group practices 1

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": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1245977198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786",
            "telephone_number": "763-274-3120",
            "fax_number": "763-274-3121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13603 80TH CIR N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553698961",
            "telephone_number": "763-274-3120",
            "fax_number": "763-274-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELLES",
        "first_name": "KALEIGH",
        "middle_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "83442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.