Kellie Nielsen, APRN, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5113808-4405 Issued in UT

Practice address

600 W Hospital Rd
Brigham City, UT 84302-3006

Phone

(435) 734-2041

Fax

(435) 723-8028

NPI assigned

Jun 13, 2016

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

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health Logan Regional Hospital Hospital, Logan, UT, CCN 460015
• Brigham City Community Hospital Hospital, Brigham City, UT, CCN 460017
• Nell J Redfield Memorial Hospital Hospital, Malad City, ID, CCN 131303
• Cache Valley Hospital Hospital, North Logan, UT, CCN 460054
• Bear River Valley Hospital Hospital, Tremonton, UT, CCN 460039

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kellie.nielsen@230919546077188.direct.elationemr.com

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.

• Wholelife Family Wellness Clinic of Providence PLLC

  • Family Nurse Practitioner
  • Providence, UT
  • NPI 1962049932
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Brigham City Community Hospital, Inc.

  • General Acute Care Hospital
  • Brigham City, UT
  • NPI 1245282227
  Care Compare affiliation
• Ihc Health Services Inc

  • General Acute Care Hospital
  • Tremonton, UT
  • NPI 1679582944
  Care Compare affiliation
• Ihc Health Services Inc

  • General Acute Care Hospital
  • Logan, UT
  • NPI 1831108497
  Care Compare affiliation
• Mountain Division - CVH, LLC

  • General Acute Care Hospital
  • North Logan, UT
  • NPI 1952703472
  Care Compare affiliation
• Oneida County Hospital

  • Critical Access Hospital
  • Malad, ID
  • NPI 1609826270
  Care Compare affiliation

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1992154777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 719",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843020719",
            "telephone_number": "435-734-2041",
            "fax_number": "435-723-8028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W HOSPITAL RD",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843023006",
            "telephone_number": "435-734-2041",
            "fax_number": "435-723-8028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "KELLIE",
        "credential": "APRN, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "5113808-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Nelson
• Michael Richard Nelson
• Cozette Newman
• Derek Nielsen
• Janae M Nielsen
• Michelle Dawn Nielsen
• Leanna Nielson
• Lilly Nielson
• Hunter Nilson
• Dustin I Norman

• Family Nurse Practitioner in Brigham City, UT
• Providers in Brigham City, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.