Kathleen Kelley, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95009506 Issued in CA

Practice address

1041 Rose Ave
Selma, CA 93662-3240

Phone

(559) 856-6090

Fax

(559) 856-6092

NPI assigned

Apr 24, 2007

Last updated

Feb 21, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Kathleen Anne Kelley Other name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1447479928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 ROSE AVE",
            "city": "SELMA",
            "state": "CA",
            "postal_code": "936623240",
            "telephone_number": "559-856-6090",
            "fax_number": "559-856-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 ROSE AVE",
            "city": "SELMA",
            "state": "CA",
            "postal_code": "936623240",
            "telephone_number": "559-856-6090",
            "fax_number": "559-856-6092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009506",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "469079",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "KELLEY",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kaiser Foundation Health Plan Inc (Kaiser Permanente Pharmacy #841)
• Kevin Kaleka, MD
• Virender Singh Kaleka, M.D.
• Sowjanya Kalidindi
• Ranjit Kaur
• Clinton Kershaw, PA-C
• Heejin Kim, PHARM.D.
• Kil Woo Kim, MD
• David R King, O.D.
• Sharon King

• Family Nurse Practitioner in Selma, CA
• Providers in Selma, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.