Kelsey Nicole Wall

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

4499 Issued in MN

Practice address

15265 Carrousel Way Ste 100
Rosemount, MN 55068-1760

Phone

(952) 443-4600

NPI assigned

May 24, 2023

Sex

Female

Sole proprietor

No

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 MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16506/brand/1/csg/1/fhir/r4

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.

• Lorenz Clinic, LLC

  • Marriage & Family Therapist
  • Victoria, MN
  • NPI 1982900510
  Medicare reassignment NPD

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1992497267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15265 CARROUSEL WAY STE 100",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550681760",
            "telephone_number": "952-443-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15265 CARROUSEL WAY STE 100",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550681760",
            "telephone_number": "952-443-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "KELSEY",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-24",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jody Voges
• Amelia Jin Yuan Volkert, DDS, MS
• Gunnar Vraa
• Serena Ann Vruno, LICSW
• Walgreen Co
• Michelle M Wall, PT/DPT, ATC
• Richard Warmke
• Katelyn Weeres
• Russell C Welch, MD
• Nicole A Welp, RN

• Marriage & Family Therapist in Rosemount, MN
• Providers in Rosemount, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.