Kelly McGregory Pediatrics LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

KELLY MCGREGORY PEDIATRICS LLC

Practice address

6000 Bass Lake Rd Ste 102
Crystal, MN 55429

Phone

(815) 975-7555

NPI assigned

Jul 31, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Kelly McGregory, DONPI 1104025279

Title

Pediatrician

Phone

(763) 334-5151

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly N McGregory, DO

  • Child Abuse Pediatrics Physician
  • Madison, WI
  • NPI 1104025279
  NPD Authorized official

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537401600000",
    "number": "1952889073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 BASS LAKE RD STE 102",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554292768",
            "telephone_number": "763-334-5151",
            "fax_number": "612-324-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 BASS LAKE RD STE 102",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "55429",
            "telephone_number": "815-975-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY MCGREGORY PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-31",
        "last_updated": "2018-09-20",
        "status": "A",
        "authorized_official_last_name": "MCGREGORY",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "763-334-5151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Jane Juell
• Kathryn G Justesen, M.D.
• Njil Kabamba I
• Jo Ellen Sullivan Kanne
• Carol M Karsnia, PA-C
• Andrea D Keys, LADC
• Pamera Kezy, MSW, LICSW
• Nabeela Khan, PA-C
• Gabriel Kimball
• Kindred Ground, LLC

• Pediatrics Physician in Crystal, MN
• Providers in Crystal, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.