Suzie Kelley, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2022041568 Issued in MO

Practice address

3515 Broadway Blvd
Kansas City, MO 64111-2501

Phone

(816) 753-5144

NPI assigned

Oct 19, 2022

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

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kansas City Care Clinic

  • Federally Qualified Health Center (FQHC)
  • Kansas City, MO
  • NPI 1215273388
  Medicare reassignment NPD
• Kansas City Care Clinic

  • Federally Qualified Health Center (FQHC)
  • Kansas City, MO
  • NPI 1437897774
  NPD
• Kansas City Care Clinic

  • Federally Qualified Health Center (FQHC)
  • Kansas City, MO
  • NPI 1770024663
  NPD

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1376269472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 BROADWAY BLVD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112501",
            "telephone_number": "816-753-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 BROADWAY BLVD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112501",
            "telephone_number": "816-753-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "SUZIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-19",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "TMP-161142",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2022041568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Kelley, MD
• Johanna Eileen Kelley, LCSW, LSCSW
• Kathleen Alverda Kelley, RN
• Katlyn Kelley, APRN
• Patrick Kelley, PHARMD
• Thomas Dennis Kelley III, MD
• Ross Allen Kelling, DPT
• Kelly Baker Chiropractic PC
• Kelly Eledge LCSW LLC
• Kelly S Baker PC

• Family Nurse Practitioner in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.