Wayne Kelly, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

27612 Issued in MN

Practice address

855 Mankato Ave
Winona, MN 55987-4868

Phone

(507) 454-5050

Fax

(507) 454-5102

NPI assigned

Apr 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Minnesota Medical School, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Winona Health ServicesGroup PAC ID 8527977420, 160 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Winona Health Services Hospital, Winona, MN, CCN 240044

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Winona Health Services

  • General Acute Care Hospital
  • Winona, MN
  • NPI 1295789352
  Medicare reassignment Care Compare group NPD
• CCM Health

  • Critical Access Hospital
  • Montevideo, MN
  • NPI 1720086028
  Medicare reassignment NPD
• Winona Health Services

  • General Practice Physician
  • Winona, MN
  • NPI 1720210099
  NPD
• River Crossings Counseling and Consulting LLC

  • Community/Behavioral Health Agency
  • Lake City, MN
  • NPI 1609489517
  NPD (past)

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

• Winona Health Services

  • General Acute Care Hospital
  • Winona, MN
  • NPI 1295789352
  Care Compare affiliation

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327622400000",
    "number": "1831153972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 MANKATO AVE",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559874868",
            "telephone_number": "507-454-5050",
            "fax_number": "507-454-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 MANKATO AVE",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559874868",
            "telephone_number": "507-454-5050",
            "fax_number": "507-454-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "WAYNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2012-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "27612",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "41795",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "503567800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace Anne Julian, LAT, ATC
• Allyson Kahler
• Joseph Kaiya, MD
• Makenna Karjalahti
• Stacey Ann Keller, PT, DPT
• Maya Honorine Kemp
• Colin Kennedy, M.D.
• Nawang K. Khambache, NP
• Eveleene Rose King
• Anjelica Mae Kinney, MAC, LAC, DIPLAC

• Family Medicine Physician in Winona, MN
• Providers in Winona, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; 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.