Individual provider Active NPI

Kelly Lee Mattson, DNP, APRN

  • Family Nurse Practitioner
  • Long Prairie, MN
National Provider Identifier
1639975964
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13219 Issued in MN
Practice address
50 Centracare Dr
Long Prairie, MN 56347-2100
Phone
(320) 732-2131
Fax
(320) 732-6913
NPI assigned
Feb 19, 2025
Last updated
Aug 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 13219 MN Primary

Addresses

Primary practice location

50 Centracare Dr
Long Prairie, MN 56347-2100

Mailing address

521 10TH Ave NE
Brainerd, MN 56401-2843
Phone (218) 851-4105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250829002782 MN Practitioner - Nurse Practitioner 0446751549 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare Health System - MelroseGroup PAC ID 1658270368, shared by 3 NPIs, 38 clinicians

Practice addresses (Care Compare)

50 Centracare Dr
Long Prairie, MN 56347-2100
Phone (320) 732-2141

525 Main St W
Melrose, MN 56352-1043
Phone (320) 256-4231

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Health System - Long Prairie CurrentSince Aug 11, 2025 Accepting new patients

Locations

50 Centracare Dr
Long Prairie, MN 56347
Phone (320) 732-2131

Interoperability endpoints

  • Direct secure messaging: kmattson884957@direct.centracare.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1739923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1639975964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 10TH AVE NE",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564012843",
            "telephone_number": "218-851-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 CENTRACARE DR",
            "city": "LONG PRAIRIE",
            "state": "MN",
            "postal_code": "563472100",
            "telephone_number": "320-732-2131",
            "fax_number": "320-732-6913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTSON",
        "first_name": "KELLY",
        "middle_name": "LEE",
        "credential": "DNP, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-19",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "13219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Prairie, MN

Sources for this page

Verify at the official NPI Registry.