Kelly Margaret McBride

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1355 North Tranquility Lane
Palmer, AK 99645

Phone

(907) 232-2510

NPI assigned

Jun 2, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Matanuska Mama, LLC

  • Case Management Agency
  • Palmer, AK
  • NPI 1629812417
  NPD Authorized official

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1962141440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3151",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996453151",
            "telephone_number": "907-232-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 NORTH TRANQUILITY LANE",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "99645",
            "telephone_number": "907-232-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBRIDE",
        "first_name": "KELLY",
        "middle_name": "MARGARET",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-02",
        "last_updated": "2022-06-02",
        "certification_date": "2022-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "AK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelbel78@live.com",
            "affiliation": "N",
            "endpointDescription": "waiting on dSm address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "pdf",
            "address_1": "1355 North Tranquility Lane",
            "city": "Palmer",
            "state": "AK",
            "country_code": "US",
            "postal_code": "99645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Matsu Baby Co LLC
• Kailey Marie Matzen, DPT
• Luke Matzen, PT, DPT
• Heaven Lynn Mayer
• Susan Lynn Mayer, LPC
• Liza Tulio McCafferty, M.S.
• Seamus R McCann
• Nicolas Mario McCaslin
• Stephanie Ann McCoy, PTA
• David Rees McDaniel

• Case Manager/Care Coordinator in Palmer, AK
• Providers in Palmer, AK by specialty
• Case Manager/Care Coordinator in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; 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.