Erik Kelly, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP-1657A Issued in ID

Practice address

265 W Prairie Shopping Ctr
Hayden, ID 83835-9855

Phone

(208) 772-7850

NPI assigned

Jun 21, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1396195269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838350038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 W PRAIRIE SHOPPING CTR",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838359855",
            "telephone_number": "208-772-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ERIK",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-21",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-1657A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucy Julien
• Richard H Justus, M.ED., BCBA
• Justin Thomas Kane, PT
• Cristy Kay, LCSW
• Susan E Keeley, LCSW
• Meghan Kelly, BS CRIMINOLOGY
• Kayla Rae Kendall, FNP
• Kevin Joseph Kervick, MS
• Jessica Minhae Kim
• Lynne Kinson, M.S.

• Family Nurse Practitioner in Hayden, ID
• Providers in Hayden, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; 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.