Kelsey Mae Dockendorf, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10392 Issued in MN

Practice address

49725 County 83
Staples, MN 56479-5280

Phone

(320) 248-5083

NPI assigned

Jul 4, 2023

Last updated

Jul 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, KS2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

University of North Dakota School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Marys Regional Health CenterGroup PAC ID 2062326820, 190 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Perham Health Hospital, Perham, MN, CCN 241373
• Ortonville Area Health Services Hospital, Ortonville, MN, CCN 241342

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

Practice roles

Locations

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.

• St. Marys Regional Health Center

  dba Essentia Health St. Mary's- Detroit Lakes

  • Rural Acute Care Hospital
  • Detroit Lakes, MN
  • NPI 1679561088
  Medicare reassignment Care Compare group
• Lakewood Health System

  dba Lakewood Clinic Staples

  • Rural Health Clinic/Center
  • Staples, MN
  • NPI 1841280823
  Medicare reassignment NPD
• Ortonville Area Health Services

  • Critical Access Hospital Clinic/Center
  • Ortonville, MN
  • NPI 1477799765
  Medicare reassignment NPD
• Ortonville Area Health Services

  • Critical Access Hospital
  • Ortonville, MN
  • NPI 1790783587
  Medicare reassignment NPD
• Perham Hospital District

  dba Perham Health

  • Critical Access Hospital
  • Perham, MN
  • NPI 1790799518
  Medicare reassignment NPD
• Greeley County Health Services, Inc

  dba Wallace County Family Practice Clinic

  • Primary Care Clinic/Center
  • Sharon Springs, KS
  • NPI 1316010317
  Medicare reassignment
• Lakewood Health System

  • Critical Access Hospital
  • Staples, MN
  • NPI 1124019054
  NPD
• Lakewood Health System

  dba Longbella Drug by Lakewood Health System - Pillager Clinic

  • Community/Retail Pharmacy
  • Pillager, MN
  • NPI 1396519906
  NPD
• Ortonville Area Health Services

  • Family Medicine Physician
  • Ortonville, MN
  • NPI 1033785449
  NPD
• Lakewood Health System

  • Critical Access Hospital
  • Staples, MN
  • NPI 1295726362
  NPD (past)

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

• Ortonville Area Health Services

  • Critical Access Hospital
  • Ortonville, MN
  • NPI 1790783587
  Care Compare affiliation
• Perham Hospital District

  dba Perham Health

  • Family Medicine Physician
  • Perham, MN
  • NPI 1457631814

  Hospital

  Care Compare affiliation
• Perham Hospital District

  dba Perham Health

  • Critical Access Hospital
  • Perham, MN
  • NPI 1790799518
  Care Compare affiliation

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

{
    "created_epoch": "1688428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1679250385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16101 WILDERNESS DR",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564793127",
            "telephone_number": "320-248-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49725 COUNTY 83",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564795280",
            "telephone_number": "320-248-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCKENDORF",
        "first_name": "KELSEY",
        "middle_name": "MAE",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-04",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "10392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frany Bipinchandra Dadhania, DO
• Larson Davick, PA-C
• Paul A Davis, PHD, LP
• Marc W Debow
• Nathan Thomas Dewey, MD
• Seth Alan Dokken, O.D.
• Karen Lynn Dornbusch, MA, CCC-A
• Constance L Dubois
• Anna Corinne Ehnstrom, PA-C
• Mattie Rose Ellenson, APRN, CNP

• Family Nurse Practitioner in Staples, MN
• Providers in Staples, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.