Samantha Kelly, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN.0995461-NP Issued in CO

Practice address

4036 Ridge Dr
Pueblo, CO 81008-1720

Phone

(719) 251-1594

Fax

(514) 236-8737

NPI assigned

Jun 28, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, CO2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/25348/brand/1/csg/1/fhir/r4
• Direct secure messaging: samantha.kelly@790278196822020.direct.elationemr.com

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.

• All Inclusive Medical Services, Inc

  • Internal Medicine Physician
  • Carmichael, CA
  • NPI 1518369891
  Medicare reassignment NPD
• Signify Health Medical Associates of California, PC

  • General Practice Physician
  • San Francisco, CA
  • NPI 1124685169
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  CO

  Medicare reassignment NPD
• Simplified Telehealth LLC

  dba Simplified Care

  • Primary Care Clinic/Center
  • Pueblo, CO
  • NPI 1467125989
  NPD Authorized official

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1518488634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4036 RIDGE DR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081720",
            "telephone_number": "719-251-1594",
            "fax_number": "514-236-8737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4036 RIDGE DR",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081720",
            "telephone_number": "719-251-1594",
            "fax_number": "514-236-8737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6960 W Peoria Ave Lot 5",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853456025",
            "country_code": "US",
            "telephone_number": "719-415-0297",
            "fax_number": "514-236-8737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SAMANTHA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-28",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0995461-NP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "337690",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006818",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95034970",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Kelley, NP-C
• Alexandra L Kellogg, DO
• Betty J Kelly
• Heather Kelly, LPC
• Jennifer Kelly
• Guy L Kemling, MD
• Paitton Nicole Kendrick-Callery
• Crystal Kennedy
• Ryan Kennedy
• Sarah Kennedy, LPN

• Family Nurse Practitioner in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; 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.