Individual provider Active NPI

Kelli Ann Lafleur, RN, FNP

  • Family Nurse Practitioner
  • Central Point, OR
National Provider Identifier
1386650398
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
084065690N1 FNP-PP Issued in OR
Practice address
4940 Hamrick Rd
Central Point, OR 97502-3072
Phone
(541) 535-6239
Fax
(541) 535-4377
NPI assigned
Jul 31, 2006
Last updated
Jan 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 084065690N1 FNP-PP OR Primary

Addresses

Primary practice location

4940 Hamrick Rd
Central Point, OR 97502-3072

Mailing address

931 Chevy Way
Medford, OR 97504-4127
Phone (541) 690-3555

Other identifiers 1

IdentifierTypeStateIssuer
024489MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
084065690N1 FNP-PPORMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1386650398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 CHEVY WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044127",
            "telephone_number": "541-690-3555",
            "fax_number": "541-535-4377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 HAMRICK RD",
            "city": "CENTRAL POINT",
            "state": "OR",
            "postal_code": "975023072",
            "telephone_number": "541-535-6239",
            "fax_number": "541-535-4377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFLEUR",
        "first_name": "KELLI",
        "middle_name": "ANN",
        "credential": "RN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "084065690N1 FNP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024489",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Central Point, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.