Active NPI
Kelly R Ihry, C.N.P.
- Nurse Practitioner
- Maple Grove, MN
National Provider Identifier
1508199423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R174987-8
- Practice address
- 9825 Hospital Dr
#205
Maple Grove, MN 55369 - Phone
- (763) 587-7000
- Fax
- (763) 587-7015
- NPI assigned
- Sep 10, 2009
- Last updated
- Mar 10, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R174987-8 | MN | Primary |
Addresses
Primary practice location
9825 Hospital Dr
#205
Maple Grove, MN 55369
Mailing address
5700 Bottineau Blvd
#210
Crystal, MN 55429
Phone (763) 587-7000
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)
- Enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R174987-8 | MN | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425945600000",
"number": "1508199423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5700 BOTTINEAU BLVD",
"address_2": "#210",
"city": "CRYSTAL",
"state": "MN",
"postal_code": "55429",
"telephone_number": "763-587-7000",
"fax_number": "763-587-7015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9825 HOSPITAL DR",
"address_2": "#205",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "55369",
"telephone_number": "763-587-7000",
"fax_number": "763-587-7015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IHRY",
"first_name": "KELLY",
"middle_name": "R",
"credential": "C.N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-10",
"last_updated": "2015-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "R174987-8",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maple Grove, MN
- Hy-Vee Inc (Hy-Vee Pharmacy (1401))
- Kara Hydukovich, LPCC, LADC
- Caitlin Icart
- Jessica Idahor, DNP, APRN, FNP-C
- Sarah Igl
- Indigenous Circles Counseling Center
- Infinite Health Collaborative, PA
- Innovative Psychological Consultants, LLC
- Integrated Nursing & Health Services Inc.
- Interventional Spine and Pain Physicians, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.