Agnes M Kelly, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

24-00797 Issued in KS

Practice address

3107 Frederick Ave Ste B
Saint Joseph, MO 64506-3082

Phone

(816) 233-9888

Fax

(816) 233-0414

NPI assigned

Jun 17, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1336982370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 GEORGE ST",
            "city": "ATCHISON",
            "state": "KS",
            "postal_code": "660022637",
            "telephone_number": "314-498-0257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3107 FREDERICK AVE STE B",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063082",
            "telephone_number": "816-233-9888",
            "fax_number": "816-233-0414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "AGNES",
        "middle_name": "M",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KS",
            "license": "24-00797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason K Karns, CRNA
• Nicholas Kaup, D.O.
• KC Integrative Health and Wellness LLC
• Haley Marie Keesaman, PA-C
• Hollie Keith, PT
• Linda Marie Kemper, MS SLP CFY
• Derek M Kendall, DPT
• Kelly Renee Kennedy
• Kerns Family Health Care LLC
• Danyelle Dawn Kerns, NP-C

• Athletic Trainer in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.