Individual provider Active NPI

Kelsey L Kuylen, FNP

  • Family Nurse Practitioner
  • Dickinson, ND
National Provider Identifier
1477007367
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R35654 Issued in ND
Practice address
30 7TH St W
Dickinson, ND 58601-4335
Phone
(701) 483-6666
Fax
(701) 483-6667
NPI assigned
Aug 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R35654 ND Primary

Addresses

Primary practice location

30 7TH St W
Dickinson, ND 58601-4335

Mailing address

PO Box 406
Dickinson, ND 58602-0406
Phone (701) 260-5724

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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

Enrollment IDStateProvider typePAC IDDetails
I20161019001480 ND Practitioner - Nurse Practitioner 3173811411 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R35654NDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Hospital and Health Center CurrentSince Oct 4, 2016 Accepting new patients
St Joseph'S Hospital and Health Center Current Accepting new patients
St Joseph'S Hospital and Health Center CurrentSince Oct 4, 2016 Accepting new patients

Locations

7360 Solutions Ctr
Chicago, IL 60677
Phone (701) 237-8033

30 7th St W
Dickinson, ND 58601
Phone (701) 264-4000

2500 Fairway St
Dickinson, ND 58601
Phone (701) 456-4000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1477007367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 406",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586020406",
            "telephone_number": "701-260-5724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 7TH ST W",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586014335",
            "telephone_number": "701-483-6666",
            "fax_number": "701-483-6667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUYLEN",
        "first_name": "KELSEY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-08",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R35654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickinson, ND

Sources for this page

Verify at the official NPI Registry.