Individual provider Active NPI

Kelly Marie Ragaller, ARNP

  • Family Nurse Practitioner
  • South Sioux City, NE
National Provider Identifier
1801992532
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
110826 Issued in NE
Practice address
3410 Futures Dr
South Sioux City, NE 68776-3917
Phone
(712) 252-2477
Fax
(712) 252-5920
NPI assigned
Sep 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A-105358 IA
Family Nurse Practitioner 363LF0000X 110826 NE Primary

Addresses

Primary practice location

3410 Futures Dr
South Sioux City, NE 68776-3917

Mailing address

1021 Nebraska St
Sioux City, IA 51105-1436
Phone (712) 252-2477

Other practice location 1

1021 Nebraska St
Sioux City, IA 51105-1436
Phone (712) 252-2477

Other identifiers 2

IdentifierTypeStateIssuer
A-105358OtherIAIA BOARD OF NURSING
110826OtherNENE APRN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070206000625 NE Practitioner - Nurse Practitioner 5092717926 Reassigns benefits to 1 organization
I20070219000097 IA Practitioner - Nurse Practitioner 5092717926 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A-105358IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Woodbury Emergency Group, PC Nurse Practitioner CurrentSince Oct 23, 2019 Accepting new patients
Siouxland Community Health Center CurrentSince Sep 10, 2018 Accepting new patients
Siouxland Community Health Center CurrentSince Sep 10, 2018 Accepting new patients
St Lukes Health Resources PastSince Dec 7, 2020 Accepting new patients
Continental Springs LLC Past Accepting new patients

Locations

1021 Nebraska St
Sioux City, IA 51105
Phone (712) 252-2477

801 5th St
Sioux City, IA 51101
Phone (712) 279-2010

3410 Futures Dr
South Sioux City, NE 68776
Phone (402) 412-4271

Interoperability endpoints

  • Direct secure messaging: kbean636986@direct.ochin.org

Organizations & group practices 5

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1801992532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 NEBRASKA ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511051436",
            "telephone_number": "712-252-2477",
            "fax_number": "712-252-5920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 FUTURES DR",
            "city": "SOUTH SIOUX CITY",
            "state": "NE",
            "postal_code": "687763917",
            "telephone_number": "712-252-2477",
            "fax_number": "712-252-5920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1021 Nebraska St",
            "address_purpose": "LOCATION",
            "city": "Sioux City",
            "state": "IA",
            "postal_code": "511051436",
            "country_code": "US",
            "telephone_number": "712-252-2477",
            "fax_number": "712-252-5920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAGALLER",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A-105358",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "110826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IA BOARD OF NURSING",
            "identifier": "A-105358",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NE APRN LICENSE",
            "identifier": "110826",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Sioux City, NE

Sources for this page

Verify at the official NPI Registry.