Jacquelin E Kelly, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

694 Gamble Oak St
Brighton, CO 80601-6633

Phone

(480) 433-7953

NPI assigned

Feb 5, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jacquelin Neely Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1992568604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "694 GAMBLE OAK ST",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806016633",
            "telephone_number": "480-433-7953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "694 GAMBLE OAK ST",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806016633",
            "telephone_number": "480-433-7953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JACQUELIN",
        "middle_name": "E",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "1004701",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELIN",
            "last_name": "NEELY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marissa Marie Keeran
• Susan Barbara Keithley, CNM
• Margaret Kelleher
• Kellogg-Paisley LLC
• Bradley Scott Kellogg, D.D.S.
• Margaret Kelly, OTR
• Mackenzie Lea Kerr, FNP
• Fitsum Kidane
• Kids City Dental and Braces, PLLC
• Kids First Health Care

• Registered Dietitian in Brighton, CO
• Providers in Brighton, CO by specialty
• Registered Dietitian in Colorado

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

Verify at the official NPI Registry.