Active NPI
Kelly Marie Mitchell
- Social Worker
- Belcourt, ND
National Provider Identifier
1811146749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- Bia Road # 7 Building #152
Belcourt, ND 58316-1970 - Phone
- (701) 477-0525
- Fax
- (701) 477-0527
- NPI assigned
- Sep 16, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
Bia Road # 7 Building #152
Belcourt, ND 58316-1970
Mailing address
PO Box 1970
Belcourt, ND 58316-1970
Phone (701) 477-0525
Other names 1
- Ms. Kelly Marie Clark
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221523200000",
"number": "1811146749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1970",
"city": "BELCOURT",
"state": "ND",
"postal_code": "583161970",
"telephone_number": "701-477-0525",
"fax_number": "701-477-0527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BIA ROAD # 7 BUILDING #152",
"city": "BELCOURT",
"state": "ND",
"postal_code": "583161970",
"telephone_number": "701-477-0525",
"fax_number": "701-477-0527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "KELLY",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-16",
"last_updated": "2008-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "CLARK",
"middle_name": "MARIE",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Belcourt, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.