Wendy Carroll Kelly

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1320 Wisconsin Ave
Racine, WI 53403-1978

Phone

(262) 687-2699

NPI assigned

Aug 17, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282003200000",
    "number": "1487969291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1737 PATRIOT WAY",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534062730",
            "telephone_number": "262-884-7137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 WISCONSIN AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031978",
            "telephone_number": "262-687-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "WENDY",
        "middle_name": "CARROLL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2010-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KDR Services Inc.
• Andrea K Keeling, PA-C
• John Thomas Keil, R.PH
• Denise A Keller, COTA
• Karl Thomas Keller, DC
• Richard John Kemper, DDS
• Mark R Kenfield, DDS
• Kenosha Community Health Center, Inc.
• Adel Khdour, MD
• Abigail Kibler

• Student in an Organized Health Care Education/Training Program in Racine, WI
• Providers in Racine, WI by specialty
• Student in an Organized Health Care Education/Training Program in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2010; 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.