Active NPI
Grace Kelley
- Registered Dietitian
- Cleveland, OH
National Provider Identifier
1962149617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86174599
- Practice address
- 1830 W 28TH St
Cleveland, OH 44113-3064 - Phone
- (440) 986-0360
- NPI assigned
- May 15, 2022
- Last updated
- Dec 5, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86174599 | OH | Primary |
Addresses
Primary practice location
1830 W 28TH St
Cleveland, OH 44113-3064
Mailing address
1400 Kingsway
Westlake, OH 44145-2613
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86174599 | OH | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grace Kelley Nutrition LLC | Dietitian, Registered | Current | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
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, 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": "1652572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733356800000",
"number": "1962149617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 KINGSWAY",
"city": "WESTLAKE",
"state": "OH",
"postal_code": "441452613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1830 W 28TH ST",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441133064",
"telephone_number": "440-986-0360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "GRACE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-15",
"last_updated": "2024-12-05",
"certification_date": "2024-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "86174599",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.