Individual provider Active NPI

Kelleigh Jean Strickland, NP

  • Nurse Practitioner
  • Bountiful, UT
National Provider Identifier
1649338856
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN146690 Issued in GA
Practice address
420 W 1500 S Ste 201
Bountiful, UT 84010-7434
Phone
(844) 209-5258
NPI assigned
Dec 4, 2006
Last updated
Feb 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN146690 GA Primary
Family Nurse Practitioner 363LF0000X R45240 ND
Family Nurse Practitioner 363LF0000X CNP5610 MN

Addresses

Primary practice location

420 W 1500 S Ste 201
Bountiful, UT 84010-7434

Mailing address

623 N Milledge Ave
Unit a
Athens, GA 30601-3803
Phone (770) 965-2699

Other practice location 1

4450 Nelson Brogdon Blvd
Buford, GA 30518-3447
Phone (770) 932-9998

Other practice location 2

181 S Clayton St
Lawrenceville, GA 30045-5716
Phone (713) 935-0333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20070416000332 GA Practitioner - Nurse Practitioner 6406951714

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN146690GAMDNurse Practitioner
CNP5610MNMDFamily Nurse Practitioner
R45240NDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rediclinic LLC 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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1649338856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 N MILLEDGE AVE",
            "address_2": "UNIT A",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306013803",
            "telephone_number": "770-965-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W 1500 S STE 201",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107434",
            "telephone_number": "844-209-5258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4450 Nelson Brogdon Blvd",
            "address_purpose": "LOCATION",
            "city": "Buford",
            "state": "GA",
            "postal_code": "305183447",
            "country_code": "US",
            "telephone_number": "770-932-9998",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "181 S Clayton St",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300455716",
            "country_code": "US",
            "telephone_number": "713-935-0333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STRICKLAND",
        "first_name": "KELLEIGH",
        "middle_name": "JEAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN146690",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R45240",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP5610",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

Verify at the official NPI Registry.