Individual provider Active NPI

Kelly Lynn Kline, FNP-C

  • Family Nurse Practitioner
  • Shenandoah, IA
National Provider Identifier
1730067299
Registry record updated Aug 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A186568 Issued in IA
Practice address
300 Pershing Ave
Shenandoah, IA 51601-2355
Phone
(712) 246-7400
NPI assigned
Aug 23, 2025
Last updated
Aug 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 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 A186568 IA Primary

Addresses

Primary practice location

300 Pershing Ave
Shenandoah, IA 51601-2355

Mailing address

907 Meadow Ridge Dr
Clarinda, IA 51632-2424
Phone (515) 450-2857

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20251030004522 IA Practitioner - Nurse Practitioner 9234628082 Reassigns benefits to 1 organization

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
Shenandoah Medical CenterGroup PAC ID 9436063237, 52 clinicians

Practice addresses (Care Compare)

1 Jack Foster Dr
Shenandoah, IA 51601-4586
Phone (712) 246-7240

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A186568IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shenandoah Medical Center CurrentSince Sep 16, 2025 Accepting new patients
Shenandoah Medical Center CurrentSince Sep 16, 2025 Accepting new patients
Shenandoah Medical Center Current Accepting new patients
Shenandoah Medical Center Past Accepting new patients

Locations

1 Jack Foster Dr
Shenandoah, IA 51601
Phone (712) 246-7240

300 Pershing Ave
Shenandoah, IA 51601
Phone (712) 246-1230

400 Main St
Tabor, IA 51653
Phone (712) 246-7245

Organizations & group practices 4

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": "1755907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755907200000",
    "number": "1730067299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 MEADOW RIDGE DR",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516322424",
            "telephone_number": "515-450-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PERSHING AVE",
            "city": "SHENANDOAH",
            "state": "IA",
            "postal_code": "516012355",
            "telephone_number": "712-246-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINE",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-23",
        "last_updated": "2025-08-23",
        "certification_date": "2025-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A186568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, IA

Sources for this page

Verify at the official NPI Registry.