Individual provider Active NPI

Kalli Joelle Underwood, RN

  • Registered Nurse
  • Columbus, OH
National Provider Identifier
1417840430
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4945502 Issued in OH
Practice address
1380 Dublin Rd Ste 100
Columbus, OH 43215-1025
Phone
(614) 488-7117
Fax
(614) 488-7118
NPI assigned
May 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4945502 OH Primary

Addresses

Primary practice location

1380 Dublin Rd Ste 100
Columbus, OH 43215-1025

Mailing address

8444 N 90TH St Ste 100
Scottsdale, AZ 85258-4437
Phone (602) 248-8886

Other names 1

  • Kalli Joelle Holland Former name

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

LicenseStateTypeSpecialty
4945502OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1748476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1417840430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8444 N 90TH ST STE 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584437",
            "telephone_number": "602-248-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 DUBLIN RD STE 100",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151025",
            "telephone_number": "614-488-7117",
            "fax_number": "614-488-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "KALLI",
        "middle_name": "JOELLE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-29",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "4945502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KALLI",
            "last_name": "HOLLAND",
            "middle_name": "JOELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; 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.