Jennifer Lynne Kelly, AGNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

2020003607 Issued in MO

Practice address

2101 Corona Rd Ste 102
Columbia, MO 65203-2582

Phone

(573) 234-1800

Fax

(573) 234-1799

NPI assigned

Jul 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jennifer.kelly@bhm.gehrimeddirect.com

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1356959944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 CORONA RD STE 102",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652032582",
            "telephone_number": "573-234-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 CORONA RD STE 102",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652032582",
            "telephone_number": "573-234-1800",
            "fax_number": "573-234-1799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JENNIFER",
        "middle_name": "LYNNE",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-20",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2009019364",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020003607",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2020003607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jennifer.Kelly@BHM.gehrimeddirect.com",
            "affiliation": "N",
            "address_1": "2101 Corona Rd Ste 102",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652032582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Morgan Kelley
• Clint W Kellogg, D.O.
• Glenda Kaye Kellogg, LCSW
• Danielle Ariana Kelly, RBT
• Dedrae Kelly, PLPC
• Kristina Marie Kelly, DPT
• Alexadra M Kelsch, RBT
• Kelsey Esser Templeton, MSW, LCSW LLC (The Current Therapy Services)
• Danielle Elizabeth Kelvas, MD
• Jennifer Nicole Kemna, RPH

• Gerontology Nurse Practitioner in Columbia, MO
• Providers in Columbia, MO by specialty
• Gerontology Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.