Active NPI
Kelsey Ann Panarra, LVN
- Licensed Vocational Nurse
- Fresno, CA
National Provider Identifier
1669057550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 292707
- Practice address
- 4441 E Kings Canyon Rd
Fresno, CA 93702-3604 - Phone
- (559) 600-9180
- NPI assigned
- Mar 12, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 292707 | CA | |
| Licensed Vocational Nurse | 164X00000X | 292707 | CA | Primary |
Addresses
Primary practice location
4441 E Kings Canyon Rd
Fresno, CA 93702-3604
Mailing address
4441 E Kings Canyon Rd
Fresno, CA 93702-3604
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 292707 | Medicaid | CA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | fresno |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 292707 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616716800000",
"number": "1669057550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4441 E KINGS CANYON RD",
"city": "FRESNO",
"state": "CA",
"postal_code": "937023604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4441 E KINGS CANYON RD",
"city": "FRESNO",
"state": "CA",
"postal_code": "937023604",
"telephone_number": "559-600-9180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANARRA",
"first_name": "KELSEY",
"middle_name": "ANN",
"name_prefix": "Miss",
"credential": "LVN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-12",
"last_updated": "2021-03-26",
"certification_date": "2021-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "292707",
"primary": false
},
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "292707",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "292707",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "fresno",
"affiliation": "N",
"address_1": "4441 E Kings Canyon Rd",
"city": "Fresno",
"state": "CA",
"country_code": "US",
"postal_code": "937023604",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.