Active NPI
David N Kelbaugh Jr., PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Des Moines, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- G170194
- Practice address
- 699 Walnut St Ste 400
Des Moines, IA 50309-3962 - Phone
- (515) 416-8830
- Fax
- (262) 260-9109
- NPI assigned
- Jul 1, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | TEMP276517 | AZ | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | G170194 | IA | Primary |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AP61337914 | WA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 847938 | NV | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 276517 | AZ | |
| Registered Nurse | 163W00000X | 169476 | IA | |
| Registered Nurse | 163W00000X | 847938 | NV | |
| Registered Nurse | 163W00000X | 276517 | AZ |
Addresses
Primary practice location
699 Walnut St Ste 400
Des Moines, IA 50309-3962
Mailing address
7426 N la Cholla Blvd
Tucson, AZ 85741-2306
Phone (520) 771-0555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
6505 216TH St SW
Suite 100
Mountlake Terrace, WA 98043-2089
Phone (425) 640-7009
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TEMP276517 | AZ | MD | Registered Nurse |
| 169476 | IA | MD | Registered Nurse |
| 276517 | AZ | MD | Psychiatric/Mental Health Nurse Practitioner |
| 847938 | NV | MD | Psychiatric/Mental Health Nurse Practitioner |
| AP61337914 | WA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mindful Therapy Group PC | Psychiatric/Mental Health | Current | Accepting new patients |
| Forefront-Rosenzweig Medical Services Professional Corporation | Current | Accepting new patients |
Locations
1633 N Mountain Ave
Upland, CA 91784
200 American Metro Blvd
Ste 112
Trenton, NJ 08619
1305 Alexander St
Centralia, WA 98531
Phone (360) 736-2823
1919 112th St SW
Everett, WA 98204
Phone (425) 249-0024
21907 64th Ave W
Ste 200
Mountlake Terrace, WA 98043
Phone (410) 258-3698
6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463
529 Jasmine St
Omak, WA 98841
Phone (509) 826-1600
101 Elliott Ave W
Ste 500
Seattle, WA 98119
Phone (206) 708-6432
320 NE 97th St
Ste A
Seattle, WA 98115
Phone (206) 323-8113
820 NW 95th St
Seattle, WA 98117
Phone (206) 781-6800
1780 Barnes Blvd SW
Tumwater, WA 98512
Phone (212) 993-7809
Interoperability endpoints
- david.kelbaugh.1@24287.direct.athenahealth.com
Organizations & group practices 2
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.
-
- Clinical Social Worker
- Mountlake Terrace, WA
- NPI 1316238678
Psychiatric/Mental Health
-
- Psychiatry Physician
- Dallas, TX
- NPI 1588101745
WA
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699660800000",
"number": "1922731470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7426 N LA CHOLLA BLVD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857412306",
"telephone_number": "520-771-0555",
"fax_number": "262-260-9109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "699 WALNUT ST STE 400",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503093962",
"telephone_number": "515-416-8830",
"fax_number": "262-260-9109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELBAUGH",
"first_name": "DAVID",
"middle_name": "N",
"name_suffix": "Jr.",
"credential": "PMHNP-BC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-01",
"last_updated": "2023-11-11",
"certification_date": "2023-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AZ",
"license": "TEMP276517",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "IA",
"license": "G170194",
"primary": true
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "WA",
"license": "AP61337914",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NV",
"license": "847938",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "AZ",
"license": "276517",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IA",
"license": "169476",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NV",
"license": "847938",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AZ",
"license": "276517",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.