Krista C Kelly, D.C.
Individual provider Active NPI Chiropractor · Minot, ND
NPI 1750351144 · NPPES record last updated Oct 31, 2008
Key facts
- NPI
- 1750351144
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 762 (ND)
- Practice address
- 1415 2ND Ave SW
Minot, ND 58701-3629 - Phone
- (701) 837-5733
- NPI assigned
- Jan 26, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kelly Chiropractic, PC
Practice addresses (Care Compare)
1415 2ND Ave SW
Minot, ND 58701-3629
Phone (701) 837-5733
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050816000834 | ND | Practitioner - Chiropractic | 6901836261 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 762 | ND | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kelly Chiropractic, PC | Chiropractor | Current |
Accepting new patients |
| Kelly Chiropractic, PC | Chiropractor | Current |
Accepting new patients |
Locations
141 N Main St
Garrison, ND 58540
Phone (701) 463-2988
1415 2nd Ave SW
Minot, ND 58701
Phone (701) 837-5733
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 762 | ND | Yes |
Addresses
Primary practice location
1415 2ND Ave SW
Minot, ND 58701-3629
Mailing address
1415 2ND Ave SW
Minot, ND 58701-3629
Phone (701) 837-5733
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13528 | Medicaid | ND |
Other providers in Minot, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.