Traci L Kelly, R.N., F.N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN0604 Issued in AZ

Practice address

349 E Coronado Rd
Phoenix, AZ 85004-1525

Phone

(602) 266-5678

Fax

(602) 264-5646

NPI assigned

May 12, 2006

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 identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Arizona Digestive Health, PC

  • Gastroenterology Physician
  • Scottsdale, AZ
  • NPI 1992981583
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1912958232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 N 7TH ST",
            "address_2": "#305",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850145059",
            "telephone_number": "602-264-9100",
            "fax_number": "602-264-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 E CORONADO RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041525",
            "telephone_number": "602-266-5678",
            "fax_number": "602-264-5646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "TRACI",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "R.N., F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN0604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE NUMBER",
            "identifier": "120390",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID NUMBER",
            "identifier": "317047",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Lynne-Walker Kelly, RN
• Scott Michael Kelly, MS, ATC, LAT
• Shana Kelly
• Sharon Ann Kelly, LCSW
• Tara Kelly, DPT
• Virginia Kelsch, NNP
• Kayla Marie Kelsen, PMHNP-BC
• James Kelsey, LPTA
• Rachel Kelsey, MD
• Christina M Kelso, AU.D.

• Family Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, 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 May 21, 2008; 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.