Jennifer Michelle Kelsey, APN

Primary specialty

Clinical Nurse SpecialistTaxonomy code 364S00000X

License

209.012384 Issued in IL

Practice address

420 NE Glen Oak Avenue, Suite 401
Peoria, IL 61603

Phone

(815) 530-4682

NPI assigned

Sep 4, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Mendota Community Hospital

  • Family Medicine Physician
  • Mendota, IL
  • NPI 1407872997
  Medicare reassignment NPD
• Ottawa Regional Hospital & Healthcare Center

  • General Acute Care Hospital
  • Ottawa, IL
  • NPI 1306971080
  Medicare reassignment NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment
• Mendota Community Hospital

  • Rural Health Clinic/Center
  • Granville, IL
  • NPI 1225877590
  NPD
• Mendota Community Hospital

  • Emergency Medicine Physician
  • Mendota, IL
  • NPI 1417973900
  NPD
• Ottawa Regional Hospital & Healthcare Center

  • Family Medicine Physician
  • Marseilles, IL
  • NPI 1558088203
  NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Ottawa Regional Hospital & Healthcare Center

  • General Acute Care Hospital
  • Peru, IL
  • NPI 1588713440
  NPD (past)

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

{
    "created_epoch": "1441324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1861860058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 NE GLEN OAK AVENUE, SUITE 401",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61603",
            "telephone_number": "815-530-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 NE GLEN OAK AVENUE, SUITE 401",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61603",
            "telephone_number": "815-530-4682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSEY",
        "first_name": "JENNIFER",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-04",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "IL",
            "license": "209.012384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jody L Kelly, M.D.
• Joseph P Kelly IV, PT
• Julie Ann Kelly, MS-CCC/SLP
• Keri S Kelly, PT
• Molly Jo Kelly, PT
• Tara A Kelsey, APRN, CNP
• Kelli Kemnetz
• Benjamin Owen Kemp, M.D.
• Edith Joy Kemp, MS RD LD
• Rachel Kempisty

• Clinical Nurse Specialist in Peoria, IL
• Providers in Peoria, IL by specialty
• Clinical Nurse Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.