KELLY ANNE TOLLEY (NPI# 1992299614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992299614 |
| Entity Type | Individual |
| Full Name | KELLY ANNE TOLLEY |
| Other Name | KELLY ANNE FLEMING |
| Credential | CNP |
| Practice Address |
1309 W 17th St Sioux Falls SD 57104-4663 |
| Mailing Address |
5817 W 51st St Sioux Falls SD 57106-1835 |
| Practice Telephone | 6053123250 |
| Practice Fax Number | 6053213251 |
| Mailing Telephone | 6052610170 |
| Enumeration Date | 2018-06-16 |
| Last Update Date | 2020-02-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
CP001383 | SD | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LX0001X |
Nurse Practitioner Specialization: Obstetrics & Gynecology |
CP001383 | SD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1309 W 17TH ST |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57104-4663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437155140 | Miroslaw A Mazurczak | Internal Medicine | 1309 W 17th St, Ste 101, Sioux Falls, SD 57104-8805 | 2005-06-27 |
| 1164064226 | Kimberly Caye Niemann | Nurse Practitioner | 1309 W 17th St, Sioux Falls, SD 57104-4663 | 2019-10-10 |
| 1982160206 | Marin Melissa Schaefer | Nurse Practitioner | 1309 W 17th St, Sioux Falls, SD 57104-4663 | 2019-02-11 |
| 1881190312 | Emily Joy Hutchinson | Counselor | 1309 W 17th St, Sioux Falls, SD 57104-4663 | 2018-04-03 |
| 1003366055 | Sanford Home Medical Equipment | Durable Medical Equipment & Medical Supplies | 1309 W 17th St, Ste G403c, Sioux Falls, SD 57104-4663 | 2016-10-13 |
| 1497127005 | Kimberly Rae Hamer | Nurse Practitioner | 1309 W 17th St, Ste 101, Sioux Falls, SD 57104-4663 | 2015-10-22 |
| 1023426350 | Heather Casper-mclay | Nurse Practitioner | 1309 W 17th St, Suite 101, Sioux Falls, SD 57104-4663 | 2014-07-30 |
| 1497163026 | Sanford Clinic | Family Medicine | 1309 W 17th St, Ste G01, Sioux Falls, SD 57104-4663 | 2014-07-28 |
| 1285906156 | Larissa L Risty | Genetic Counselor, MS | 1309 W 17th St, Sioux Falls, SD 57104-4663 | 2012-02-07 |
| 1346529211 | Sanford Clinic | Radiology | 1309 W 17th St, Sioux Falls, SD 57104-4663 | 2011-08-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518594134 | Melissa Bader | Nurse Practitioner | 1112 S. Lake Ave, Suite 201, Sioux Falls, SD 57104 | 2020-03-24 |
| 1457995714 | Sanford Clinic | Clinic/Center | 1112 S Lake Ave, Ste 201, Sioux Falls, SD 57104 | 2019-10-30 |
| 1427555002 | Sanford Clinic | Family Medicine | 136 S Phillips Ave Ste 102, Sioux Falls, SD 57104 | 2018-04-10 |
| 1033637210 | Anna Peasley | Speech-Language Pathologist | 710 W 18th St, Sioux Falls, SD 57104 | 2017-09-07 |
| 1699204313 | Sioux Falls Primary Home Care Services LLC | In Home Supportive Care | 201 N Minnesota Ave Ste 101l, Sioux Falls, SD 57104 | 2017-06-06 |
| 1093258808 | Megan Regina Wexler | Social Worker | 4510 N Lewis Ave, Sioux Falls, SD 57104 | 2016-11-28 |
| 1831645498 | Ryan Ortiz | Specialist/Technologist | 1908 1/2 Old Town Rd Nw, Albuquerque, NM 57104 | 2016-09-01 |
| 1881140622 | Kristine Carol Smith | Occupational Therapist | 601 N. Spring Ave, Hawthorne Elementary, Sioux Falls, SD 57104 | 2016-08-31 |
| 1215299292 | Jolene Mitchell | Preventive Medicine | 900 E 54th St N Ste 100, Sioux Falls, SD 57104 | 2012-06-14 |
| 1871874651 | Christine Marie Burg | Pharmacist | 2503 East 54th Street N., Medvantx Pharmacy Services, Sioux Falls, SD 57104 | 2011-09-07 |
| Find all providers in zip 57104 | ||||
| Taxonomy Code | 363LX0001X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Obstetrics & Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760838098 | Stacy Marie Bissoon | Nurse Practitioner | 414 W 18th St, Sioux Falls, SD 57104-4810 | 2016-05-05 |
| 1033403233 | Jennifer Susanne Senge | Nurse Practitioner | 1500 W 22nd St, Suite 301, Sioux Falls, SD 57105-7702 | 2011-06-06 |
| 1558367219 | Dianna L Puttmann | Nurse Practitioner | 1500 W 22nd St, Ste 301, Sioux Falls, SD 57105-1503 | 2005-06-27 |
| City | SIOUX FALLS |
| Zip Code | 57104 |
Please comment or provide details below to improve the information on KELLY ANNE TOLLEY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.