Individual provider Active NPI

Kelli M Soucie

  • Dental Hygienist
  • Kearney, NE
National Provider Identifier
1861291833
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
2993 Issued in NE
Practice address
2501 30TH Ave Ste a
Kearney, NE 68845-4015
Phone
(308) 293-4212
NPI assigned
Mar 11, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 2993 NE Primary

Addresses

Primary practice location

2501 30TH Ave Ste a
Kearney, NE 68845-4015

Mailing address

2501 30TH Ave Ste a
Kearney, NE 68845-4015
Phone (308) 293-4212

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

State licenses

LicenseStateTypeSpecialty
2993NEMDAddiction Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1741651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1861291833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 30TH AVE STE A",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688454015",
            "telephone_number": "308-293-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 30TH AVE STE A",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688454015",
            "telephone_number": "308-293-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUCIE",
        "first_name": "KELLI",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-11",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NE",
            "license": "2993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.