Kelli Marie Cameron Udelhofen, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

DO-05684 Issued in IA

Practice address

1026 A Ave NE
Cedar Rapids, IA 52402-5074

Phone

(319) 369-7155

Fax

(319) 861-6768

NPI assigned

Jun 18, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kudelhofen790936@direct.unitypoint.org

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.

• St. Luke'S Methodist Hospital

  • Cardiovascular Disease Physician
  • Cedar Rapids, IA
  • NPI 1073553939
  Medicare reassignment NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• Trinity Regional Medical Center

  • Emergency Medicine Physician
  • Fort Dodge, IA
  • NPI 1073594156
  NPD (past)
• Nationwide Children'S Hospital

  • Dental Clinic/Center
  • Columbus, OH
  • NPI 1407013964
  NPD (past)

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1962663468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 A AVE NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025074",
            "telephone_number": "319-369-7155",
            "fax_number": "319-861-6768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 A AVE NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025074",
            "telephone_number": "319-369-7155",
            "fax_number": "319-861-6768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDELHOFEN",
        "first_name": "KELLI",
        "middle_name": "MARIE CAMERON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-18",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101019430",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34.012337",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "DO-05684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gloire Turu
• Madison Elizabeth Tustian, MD (JUNE 2018)
• Matthew A. Tyc
• Lanny Burns Tygrett, L.M.S.W.
• Cody Tyo, LMSW
• Carl Lynn Uhlenhopp, PT
• Dana Marie Ukiri, FNP
• Janelle Marie Ullrich
• Michelle Lynn Umbarger-Mackey, PHD, ARNP, PMHNP-BC
• Scott Anor Umberfield, DDS

• Pediatrics Physician in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Pediatrics Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.