Kelly K Raney, RN, FNP, CS

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

099454 Issued in MO

Practice address

12639 Old Tesson Rd
Saint Louis, MO 63128-2786

Phone

(314) 849-0311

Fax

(314) 849-4423

NPI assigned

Nov 29, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Nurse Practitioner

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Citizens Memorial HealthcareGroup PAC ID 4183528169, 144 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Citizens Memorial Hospital Hospital, Bolivar, MO, CCN 260195

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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.

• Citizens Memorial Healthcare

  • Surgery Physician
  • Bolivar, MO
  • NPI 1568566131
  Medicare reassignment Care Compare group NPD
• Citizens Memorial Healthcare

  • Rural Health Clinic/Center
  • Willard, MO
  • NPI 1568127397
  NPD
• Comprehensive Wellness Clinic

  • Psychiatry Physician
  • Bolivar, MO
  • NPI 1619062445
  NPD (past)
• Northwoods Psychiatric Services Inc

  • Psychiatry Physician
  • Bolivar, MO
  • NPI 1417902305
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Citizens Memorial Hospital District

  • General Acute Care Hospital
  • Bolivar, MO
  • NPI 1003981549
  Care Compare affiliation

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1801963715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 N BUTTERFIELD RD",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656131056",
            "telephone_number": "417-777-8131",
            "fax_number": "417-777-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12639 OLD TESSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282786",
            "telephone_number": "314-849-0311",
            "fax_number": "314-849-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANEY",
        "first_name": "KELLY",
        "middle_name": "K",
        "credential": "RN, FNP, CS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "099454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "427759113",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Randolph
• Katherine M Randolph, LPC, NCC
• Quinten Randolph
• Sarah Randolph, PHARMD. RPH
• Deborah A Raney, FNP
• Mary Reed Raney, MSN,RNC,NNP
• Meaghan Nicole Raney, D.O.
• Sarah Marie Raney, ACNP
• Timothy Patrick Raney, MS, LPC
• Prabha Ranganathan, MD

• Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.