Individual provider Active NPI

Rachel A Kelley

  • Social Worker
  • Monona, WI
National Provider Identifier
1912651332
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
11517-123 Issued in WI
Practice address
300 Femrite Dr
Monona, WI 53716-3716
Phone
(920) 728-7046
NPI assigned
Feb 4, 2022
Last updated
Jul 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 17626-132 WI
Social Worker 104100000X 11517-123 WI Primary

Addresses

Primary practice location

300 Femrite Dr
Monona, WI 53716-3716

Mailing address

300 Femrite Dr
Monona, WI 53716-3716

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251009000179 WI Practitioner - Clinical Social Worker 6305343955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tellurian, Inc.Group PAC ID 6204925365, 7 clinicians

Practice addresses (Care Compare)

300 Femrite Dr
Monona, WI 53716-3716
Phone 6082227311119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17626-132WIMDAddiction (Substance Use Disorder) Counselor
11517-123WIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tellurian, Inc. Multi-Specialty CurrentSince Jul 11, 2025 Accepting new patients
Tellurian, Inc. CurrentSince Jul 11, 2025 Accepting new patients
Tellurian, Inc. Multi-Specialty Current Accepting new patients

Locations

1053 Williamson St
Madison, WI 53703
Phone (608) 258-3446

300 Femrite Dr
Monona, WI 53716
Phone (608) 222-7311

5900 Monona Dr
Ste 300
Monona, WI 53716
Phone (608) 222-7311

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1912651332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 FEMRITE DR",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537163716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FEMRITE DR",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537163716",
            "telephone_number": "920-728-7046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "RACHEL",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-04",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "17626-132",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "11517-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monona, WI

Sources for this page

Verify at the official NPI Registry.