Individual provider Active NPI

Kelsey Marie Hupp, FNP-C

  • Family Nurse Practitioner
  • Pierre, SD
National Provider Identifier
1750865192
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP001443 Issued in SD
Practice address
100 Mac LN
Pierre, SD 57501-3391
Phone
(605) 224-5901
NPI assigned
Sep 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

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 CP001443 SD Primary

Addresses

Primary practice location

100 Mac LN
Pierre, SD 57501-3391

Mailing address

112 Bulow Dr
Pierre, SD 57501-3806
Phone (605) 515-3491

Other names 1

  • Miss Kelsey Marie Richter Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20181218001321 SD Practitioner - Nurse Practitioner 0042555120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera St MarysGroup PAC ID 0143134965, 97 clinicians

Practice addresses (Care Compare)

801 E Sioux Ave
Pierre, SD 57501-3323
Phone (605) 224-5901

Hospital & facility affiliations

  • Avera St Mary'S Hospital Hospital, Pierre, SD, CCN 430015

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CP001443SDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avera St Marys CurrentSince Oct 2, 2018 Accepting new patients
Avera St Marys Current Accepting new patients
Avera St Marys CurrentSince Oct 2, 2018 Accepting new patients
Avera McKennan Family Past Accepting new patients

Locations

100 Mac Ln
Pierre, SD 57501
Phone (605) 224-5901

Interoperability endpoints

  • Direct secure messaging: kelsey.hupp@avera.sdhealthlink.net

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1537488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1750865192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 BULOW DR",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575013806",
            "telephone_number": "605-515-3491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAC LN",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575013391",
            "telephone_number": "605-224-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUPP",
        "first_name": "KELSEY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-21",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP001443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "RICHTER",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pierre, SD

Sources for this page

Verify at the official NPI Registry.