Kelly Magrum, CNA

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

309 Washington Ave
Williston, ND 58801-5258

Phone

(701) 580-4801

NPI assigned

Jun 15, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Kelly Magrum Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1427626415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 SHELBURNE ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585035605",
            "telephone_number": "701-570-0482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 WASHINGTON AVE",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588015258",
            "telephone_number": "701-580-4801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "621 42nd St E Apt 1018",
            "address_purpose": "LOCATION",
            "city": "Williston",
            "state": "ND",
            "postal_code": "588016844",
            "country_code": "US",
            "telephone_number": "701-570-0482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAGRUM",
        "first_name": "KELLY",
        "credential": "CNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "ND",
            "license": null,
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1482572",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MAGRUM",
            "credential": "KELLY HAGA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karen M. Luther, L.S.W.
• Michelle Lux
• Shelly Lynch
• Jocelynn Maclean
• Emily Marin Madsen, PHARMD
• Edward Douglas Maisey Jr., DDS
• Edward Douglas Maisey, DDS
• William Henry Maisey, DDS
• Michelle Joan Manire
• Charity O Manuels-Onoja

• Specialist in Williston, ND
• Providers in Williston, ND by specialty
• Specialist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.