Active NPI
Kay D. Kelly, R.N., L.AC.
- Acupuncturist
- Plymouth, MN
National Provider Identifier
1417198300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 1015
- Practice address
- 12220 45TH Ave N
Plymouth, MN 55442-2443 - Phone
- (763) 213-9989
- NPI assigned
- Mar 23, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 1015 | MN | Primary |
Addresses
Primary practice location
12220 45TH Ave N
Plymouth, MN 55442-2443
Mailing address
12220 45TH Ave N
Plymouth, MN 55442-2443
Phone (763) 213-9989
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1015 | MN | MD | Lay Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kay Kelly Traditional Chinese Medicine, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinic/Center
- Plymouth, MN
- NPI 1992036883
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237766400000",
"number": "1417198300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12220 45TH AVE N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554422443",
"telephone_number": "763-213-9989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12220 45TH AVE N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554422443",
"telephone_number": "763-213-9989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "KAY",
"middle_name": "D.",
"credential": "R.N., L.AC.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-23",
"last_updated": "2009-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "MN",
"license": "1015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.