Individual provider Active NPI

Jessica Jeanne Kegley, LMFT

  • Marriage & Family Therapist
  • Elk River, MN
National Provider Identifier
1598142010
Registry record updated Jun 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2300 Issued in MN
Practice address
11070 183Rd Cir NW
Elk River, MN 55330-2861
Phone
(763) 633-5111
Fax
(763) 633-5112
NPI assigned
May 5, 2015
Last updated
Jun 22, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2300 MN Primary

Addresses

Primary practice location

11070 183Rd Cir NW
Elk River, MN 55330-2861

Mailing address

11070 183Rd Cir NW
Elk River, MN 55330-2861
Phone (763) 633-5111

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2300MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hardy & Stephens Counseling Associates PLLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1598142010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11070 183RD CIR NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553302861",
            "telephone_number": "763-633-5111",
            "fax_number": "763-633-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11070 183RD CIR NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553302861",
            "telephone_number": "763-633-5111",
            "fax_number": "763-633-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEGLEY",
        "first_name": "JESSICA",
        "middle_name": "JEANNE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-05",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk River, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.

Verify at the official NPI Registry.