KIMBERLY RAE KELLY MD NPI 1245223023

NPI Information

  • NPI: 1245223023
  • Provider Name: KIMBERLY RAE KELLY, MD
  • Classification: Dermatology - 207N00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1702 UNIVERSITY DR S
    FARGO, ND
    ZIP 58103
  • Phone: (701) 364-3300

Map and Directions

Get Directions

NPI Details

Kimberly Rae Kelly, MD is a dermatology in Fargo, ND. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. Kimberly Rae Kelly, MD NPI is 1245223023. 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:

1702 UNIVERSITY DR S
FARGO, ND
ZIP 58103-940
Phone: (701) 364-3300
Fax: (701) 364-8906

The NPI 1245223023 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 8/26/2005 and was last updated on 8/25/2011.

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
1207N00000XDermatology33100MINNESOTANo
2207N00000XDermatology5817NORTH DAKOTAYes

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
116323MEDICAIDNORTH DAKOTA
2511R8KEOTHERMINNESOTABLUE SHIELD
30300403OTHERMEDICA
4HP17495OTHERHEALTHPARTNERS
525535OTHERNORTH DAKOTABLUE SHIELD
6N713486MEDICARE PINNORTH DAKOTA
7772090400OTHERMINNESOTAMEDICAL ASSISTANCE
8B54080MEDICARE UPIN

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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.