Individual provider Active NPI

Kelsie Rae Whitaker, FNP-C

  • Family Nurse Practitioner
  • Des Moines, IA
National Provider Identifier
1811667330
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71011510A Issued in IN
Practice address
1200 Pleasant St
Des Moines, IA 50309-1406
Phone
(515) 241-5750
NPI assigned
Sep 16, 2021
Last updated
Sep 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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 71011510A IN Primary

Addresses

Primary practice location

1200 Pleasant St
Des Moines, IA 50309-1406

Mailing address

4208 Cherrywood CT
West Des Moines, IA 50265-5368
Phone (317) 965-2573

Other identifiers 1

IdentifierTypeStateIssuer
300055315MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, 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
I20211001001979 IN Practitioner - Nurse Practitioner 8022416262 Reassigns benefits to 1 organization
I20221208000199 IA Practitioner - Nurse Practitioner 8022416262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Iowa Hospital CorporationGroup PAC ID 1052229275, 233 clinicians

Practice addresses (Care Compare)

1200 Pleasant St
Des Moines, IA 50309-1406
Phone (515) 241-5926

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71011510AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Iowa Hospital Corporation CurrentSince Jan 3, 2023 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Central Iowa Hospital Corporation Family Current Accepting new patients
Community Physicians of Indiana Inc CurrentSince Nov 18, 2021 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Nov 18, 2021 Accepting new patients
Central Iowa Hospital Corporation CurrentSince Jan 3, 2023 Accepting new patients

Locations

1200 Pleasant St
Des Moines, IA 50309
Phone (515) 241-5926

1200 Pleasant St
#206
Des Moines, IA 50309
Phone (515) 241-5100

5819 Reliable Pkwy
Chicago, IL 60686

1629 Medical Arts Blvd
#120
Anderson, IN 46011
Phone (765) 298-2400

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

7979 N Shadeland Ave
Indianapolis, IN 46250
Phone (317) 621-2627

7979 N Shadeland Ave
Ste 200
Indianapolis, IN 46250
Phone (317) 621-4300

Interoperability endpoints

  • Direct secure messaging: kscaringe7919@ecommunitydirect.com
  • Direct secure messaging: kscaringe932744@direct.unitypoint.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1811667330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4208 CHERRYWOOD CT",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502655368",
            "telephone_number": "317-965-2573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 PLEASANT ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091406",
            "telephone_number": "515-241-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "KELSIE",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71011510A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300055315",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.