Kary Anne Kelly, NP-PP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

201701664NP-PP Issued in OR

Practice address

3860 Crater Lake Ave
Medford, OR 97504-9741

Phone

(541) 858-1003

Fax

(541) 857-4499

NPI assigned

Apr 13, 2016

Sex

Female

Sole proprietor

No

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.

• Allergy & Asthma Center of Southern Oregon PC

  • Allergy Physician
  • Klamath Falls, OR
  • NPI 1164562401
  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 13, 2020.

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1356795504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 CRATER LAKE AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049741",
            "telephone_number": "541-858-1003",
            "fax_number": "541-857-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 CRATER LAKE AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049741",
            "telephone_number": "541-858-1003",
            "fax_number": "541-857-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KARY",
        "middle_name": "ANNE",
        "credential": "NP-PP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201701664NP-PP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "29710.1511",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500724440",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon Elizabeth Kellington, LCSW
• Sarah Louise Kellogg
• Emma Kelly-Robinson, LCSW
• Merrick Kelly-Robinson, LPC
• Bradley G. Kelly, P.T.
• Rose Kathleen Kelly
• Sarah Ann Kelly
• William Michael Kelly, RPH
• Melanie Marcia Kelsey, LCSW
• Benjamin Kelso

• All providers in Medford, OR
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.