Individual provider Active NPI

Kelly Marie Stormes, NP

  • Family Nurse Practitioner
  • Banning, CA
National Provider Identifier
1326356908
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19863 Issued in CA
Practice address
6109 W Ramsey St
Banning, CA 92220-3051
Phone
(951) 845-0313
NPI assigned
Sep 17, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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 19863 CA Primary

Addresses

Primary practice location

6109 W Ramsey St
Banning, CA 92220-3051

Mailing address

PO Box 10069
San Bernardino, CA 92423-0069
Phone (909) 335-4188

Other names 1

  • Kelly Marie Mead Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130802000292 CA Practitioner - Nurse Practitioner 4183865124 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1180 N Indian Canyon Dr
Suite E319
Palm Springs, CA 92262-4809
Phone (700) 325-1203

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19863CAMDCritical Care Certified Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Beaver Medical Group P C CurrentSince Jun 10, 2013 Accepting new patients
Beaver Medical Group P C CurrentSince Jun 10, 2013 Accepting new patients
Desert Heart Physicians Medical Group, Inc. CurrentSince Mar 3, 2025 Accepting new patients
Desert Heart Physicians Medical Group, Inc. CurrentSince Mar 3, 2025 Accepting new patients

Locations

6109 W Ramsey St
Banning, CA 92220
Phone (909) 845-0313

41990 Cook St
Ste 601
Palm Desert, CA 92211
Phone (760) 360-4446

1180 N Indian Canyon Dr
Ste E319
Palm Springs, CA 92262
Phone (700) 325-1203

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

2 W Fern Ave
#1112
Redlands, CA 92373

1615 Orange Tree Ln
Redlands, CA 92374
Phone (909) 335-4102

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kelly.stormes.p39@direct.mydohc.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1284681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1326356908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10069",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230069",
            "telephone_number": "909-335-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6109 W RAMSEY ST",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922203051",
            "telephone_number": "951-845-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORMES",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-17",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "19863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MEAD",
            "middle_name": "MARIE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Banning, CA

Sources for this page

Verify at the official NPI Registry.