Kelly S. Beals, Inc.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

1076 Issued in OK

Legal business name

KELLY S. BEALS, INC.

Practice address

3220 Rockhampton Ave
Oklahoma City, OK 73179-1223

Phone

(405) 795-8535

NPI assigned

Jul 16, 2008

Last updated

Jul 16, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kelly S. Beals, RD/LD

Title

Dietitian

Phone

(405) 795-8535

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1588828826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 ROCKHAMPTON AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731791223",
            "telephone_number": "405-795-8535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 ROCKHAMPTON AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731791223",
            "telephone_number": "405-795-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY S. BEALS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-16",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "BEALS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "DIETITIAN",
        "authorized_official_telephone_number": "405-795-8535",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RD/LD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "1076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI (PRIOR TO FORMING CORPORATION)",
            "identifier": "1013017003",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200089850A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED DIETITIAN",
            "identifier": "863540",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED DIETITIAN",
            "identifier": "1076",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judy Kay Kellogg, ARNP
• Julie Jo Kellogg, LMFT
• Kelly Klontz DDS,PLLC
• Kelly Medical, PC (Kelly Family Medicine)
• Kelly Morgan, LMFT, LLC
• Amanda Kaye Kelly
• Erika Lauren Kelly, LMSW
• Erin Collette Kelly, M.D.
• Faith Louise Kelly
• Imunique Kelly

• Registered Dietitian in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Registered Dietitian in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; 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.