NPIMap

Individual provider Active NPI

Mark Kelley, N.D., L.AC

  • Naturopath
  • Fort Collins, CO
National Provider Identifier
1760645865
Registry record updated Jul 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
66 Issued in MT
Practice address
209 E Swallow Rd
Fort Collins, CO 80525-2539
Phone
(970) 223-7425
NPI assigned
Jul 8, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 996 CO
Naturopath 175F00000X 66 MT Primary

Addresses

Primary practice location

209 E Swallow Rd
Fort Collins, CO 80525-2539

Mailing address

209 E Swallow Rd
Fort Collins, CO 80525-2539
Phone (970) 223-7425

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

State licenses

LicenseStateTypeSpecialty
996COMDAcupuncturist
66MTMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Jessica Kraus LMT Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215475200000",
    "number": "1760645865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 E SWALLOW RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805252539",
            "telephone_number": "970-223-7425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 E SWALLOW RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805252539",
            "telephone_number": "970-223-7425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "N.D., L.AC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-08",
        "last_updated": "2008-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CO",
            "license": "996",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "MT",
            "license": "66",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.