Ryan Patrick Kelly

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35422 Issued in MN

Practice address

701 Hewitt Blvd
Red Wing, MN 55066-2848

Phone

(651) 267-5000

NPI assigned

May 1, 2006

Last updated

Jan 30, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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 Medicine

State licenses

Practice roles

Locations

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.

• Fairview Clinics

  dba Fairview Clinics-Hiawatha

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment NPD
• Mayo Clinic Health System-Lake City

  • Critical Access Hospital
  • Lake City, MN
  • NPI 1538113022
  Medicare reassignment NPD
• Fairview Clinics

  dba Fairview Clinics-Edina

  • Primary Care Clinic/Center
  • Edina, MN
  • NPI 1346432200
  NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1982661120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "651-267-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 HEWITT BLVD",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662848",
            "telephone_number": "651-267-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "RYAN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "35422",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "35422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Allen Kasal, M.D.
• Kathryn Zoff Seivert PHD LP PA
• Jacalyn Anne Bossen Kawiecki, MD, MHA
• Gregory A Kays, MD
• Autumn Margaret Kelly
• Samantha Kennedy
• Scott Philip Ketterling, D.C.
• Megan Lynn Kindom, MD
• Brittany Michele Kingston, AAS
• Nicole Kirchner, LPCC

• Family Medicine Physician in Red Wing, MN
• Providers in Red Wing, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.