Kelley Robin Farley, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

219372 Issued in AZ

Practice address

1690 McCulloch Blvd N Ste 102
Lake Havasu City, AZ 86403-6560

Phone

(480) 404-4896

NPI assigned

Dec 17, 2018

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

Other names 1

• Ms. Kelley Robin Farley Professional name

Medicare fee-for-service enrollment

Enrolled in AZ

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.

• Vip IV & Medical Spa, LLC

  • Family Medicine Physician
  • Lake Havasu City, AZ
  • NPI 1447932280
  NPD Authorized official

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1861963845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1747 LOS LAGOS DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036625",
            "telephone_number": "480-404-4896",
            "fax_number": "480-400-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 MCCULLOCH BLVD N STE 102",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036560",
            "telephone_number": "480-404-4896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARLEY",
        "first_name": "KELLEY",
        "middle_name": "ROBIN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "219372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY",
            "last_name": "FARLEY",
            "middle_name": "ROBIN",
            "prefix": "MS.",
            "credential": "FNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Family Care Home Health & Hospice
• Family Primary Care, LLC
• Cinderella Famutimi, CRNA
• Zachary D. Fandrich, ATC
• Aubrey Fanning, PHARMD
• Carissa Farrington, SLP
• Kenneth William Fausett Sr., LMFT
• Feelin' Good Fitness LLC
• Laurie Feest, OTR,CHT,LLCC
• Feighner Therapy & Counseling, PC

• Family Nurse Practitioner in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.