Kimberly Anne Kelley, NNP

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

104406946 Issued in MO

Practice address

615 S New Ballas Rd
Saint Louis, MO 63141-8221

Phone

(314) 251-6450

NPI assigned

Jul 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kimberly Mooney Former name

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": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1346894755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2068 BELLTOWER DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633767200",
            "telephone_number": "636-866-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-25",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2013024201",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "MO",
            "license": "104406946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "MOONEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephen M Keller, M.D.
• Zachary Keller, MD
• Kristen Kellerman, PMHNP
• Colby Lynn Kelley, LSW
• Dan O. Kelley, PT
• Lenell E Kelley, MAP BCBA LBA
• Lauren Kellner, RN, BSN, IBCLC
• Cheryl A Kellogg
• Megan A Kellon, CRNA
• Amy Frances Kells, MD PHD

• Neonatal Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Neonatal Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.