Individual provider Active NPI

Marjorie L Kelsey, FNP

  • Family Nurse Practitioner
  • Traverse City, MI
National Provider Identifier
1285650903
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704109396 Issued in MI
Practice address
1200 Sixth St Ste 200
Traverse City, MI 49684-2369
Phone
(231) 935-5800
Fax
(231) 935-5799
NPI assigned
Jul 14, 2006
Last updated
Dec 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2020

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 4704109396 MI Primary

Addresses

Primary practice location

1200 Sixth St Ste 200
Traverse City, MI 49684-2369

Mailing address

2891 Momentum PL
Chicago, IL 60689-5328
Phone (231) 935-6080

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkelsey2@direct.mhc.net

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)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indigo Hospital Medicine - Traverse City, PLC Past Accepting new patients
Munson Healthcare Grayling Past Accepting new patients
MHSN Mercy Family Medicine Past Accepting new patients
Mercy Hospital Grayling Past Accepting new patients
Indigo Services, PLC Past Accepting new patients
Munson Medical Center Past Accepting new patients
Mercy Professional Services Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mkelsey2@direct.mhc.net

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1285650903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2891 MOMENTUM PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606895328",
            "telephone_number": "231-935-6080",
            "fax_number": "231-935-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SIXTH ST STE 200",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842369",
            "telephone_number": "231-935-5800",
            "fax_number": "231-935-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSEY",
        "first_name": "MARJORIE",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704109396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkelsey2@direct.mhc.net",
            "affiliation": "N",
            "address_1": "1200 Sixth St Ste 200",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496842369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; 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.