Active NPI
Kellie Lee Rock, RN
- Registered Nurse
- Box Elder, MT
National Provider Identifier
1730698952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 17988
- Practice address
- 96 Clinic Rd N
Box Elder, MT 59521-8849 - Phone
- (406) 395-4486
- Fax
- (406) 395-4138
- NPI assigned
- Sep 20, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 17988 | MT | Primary |
Addresses
Primary practice location
96 Clinic Rd N
Box Elder, MT 59521-8849
Mailing address
96 Clinic Rd N
Box Elder, MT 59521-8849
Phone (406) 395-4486
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17988 | Other | MT | RN |
Other names 1
- Kellie Lee Freeman
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17988 | MT | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1730698952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "96 CLINIC RD N",
"city": "BOX ELDER",
"state": "MT",
"postal_code": "595218849",
"telephone_number": "406-395-4486",
"fax_number": "406-395-4138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "96 CLINIC RD N",
"city": "BOX ELDER",
"state": "MT",
"postal_code": "595218849",
"telephone_number": "406-395-4486",
"fax_number": "406-395-4138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROCK",
"first_name": "KELLIE",
"middle_name": "LEE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-20",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MT",
"license": "17988",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN",
"identifier": "17988",
"state": "MT"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KELLIE",
"last_name": "FREEMAN",
"middle_name": "LEE",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Box Elder, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.