KARY ANNE KELLY NP-PP NPI 1356795504

NPI Information

NPI: 1356795504
Provider Name: KARY ANNE KELLY, NP-PP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: ALLERGY AND ASTHMA CENTER OF SOUTHERN OREGON, PC

PECOS Registration: Yes

Address:
3860 CRATER LAKE AVE
MEDFORD, OR
ZIP 97504
Phone: (541) 858-1003
Get Directions

Kary Anne Kelly, NP-PP is a family nurse practitioner in Medford, OR with 9 years of experience. Kary Anne Kelly, NP-PP NPI is 1356795504. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3860 CRATER LAKE AVE
MEDFORD, OR
ZIP 97504-741
Phone: (541) 858-1003
Fax: (541) 857-4499

The NPI 1356795504 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/13/2016 and was last updated on 7/13/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	29710.1511	WYOMING	No
2	363LF0000X	Nurse Practitioner	Family	201701664NP-PP	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	500724440	MEDICAID	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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