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AUTUMN ROSE KELLY RD, LD
NPI 1205232634
Dietitian, Registered in Marshalltown, IA

Active since November 12, 2014Accepts Medicare Assignment
3 S 4TH AVE, FOOD AND NUTRITION SERVICES, MARSHALLTOWN, IA 50158(641) 754-5271 Get Directions Write a Review

NPPES record last updated: November 12, 2014. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Autumn Rose Kelly Rd, Ld NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AUTUMN ROSE KELLY RD, LD (NPI 1205232634) is an individual dietitian, registered in Marshalltown, Iowa, licensed in Iowa (002148) and active in the NPI registry since November 2014. She is a graduate of Other (2011).

NPPES Registry Identity

NPI1205232634
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameAUTUMN ROSE KELLYCredential: RD, LD
Location Address3 S 4TH AVE, FOOD AND NUTRITION SERVICESMarshalltown, IA 50158-2924
Mailing Address23767 667th AveNevada, IA 50201-7616 · (319) 480-5574
Phone(641) 754-5271
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateNovember 12, 2014
✔ NPI 1205232634 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in IA · 002148
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
3 S 4TH AVE, Marshalltown, IA 50158
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Autumn Rose Kelly Rd, Ld is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3072836535
PECOS Enrollment IDI20260327001934, I20260331004242, I20260401000772, I20260401002858

Medicare Billing Reassignment

Medicare enrollment records show Autumn Kelly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Upperline Healthcare, PC
684 mi
Foot & Ankle Surgery
2116 CHAPEL HILL RD
Hoover, AL 35216
  • Reassigned Medicare billing, Florida, Georgia, Kentucky and Tennessee enrollments
  • 157 clinicians in this Medicare group
NPI 1538686498 (407) 219-5402

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 50158 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $52.96 – $161.40
Typical copayment $0.00 (range $13.24 – $40.35)
Most-billed visit code NA
Established Patient
$94.05 typical visit price
range $16.91 – $131.98
Typical copayment $23.51 (range $4.22 – $32.99)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMMALINE M WRIGHT RD
Dietitian, Registered
3 S 4TH AVE
MARSHALLTOWN, IA 50158
Marshall County (641) 754-5151
JEFF WHEELER
Nurse Anesthetist, Certified Registered
3 S 4TH AVE
MARSHALLTOWN, IA 50158
Marshall County (208) 830-9101
SALAHUDDIN SYED MD PC
Pathology (Anatomic Pathology & Clinical Pathology)
3 S 4TH AVE
MARSHALLTOWN, IA 50158
Marshall County (800) 288-8325
FRANCES C ARMSTEAD
Dietitian, Registered
3 S 4TH AVE
MARSHALLTOWN, IA 50158
Marshall County (641) 754-5151
DR. ERIC J STENBERG DO
Family Medicine
3 S 4TH AVE
MARSHALLTOWN, IA 50158
Marshall County (641) 754-5040
DR. MARIA GUNNES SIBBEL PHARMD
Pharmacist
3 S 4TH AVE
MARSHALLTOWN, IA 50158
Marshall County (641) 754-5100
BLAINE BRIAN WESTEMEYER M.D.
Family Medicine
3 S 4TH AVE
MARSHALLTOWN, IA 50158
Marshall County (641) 754-5145
DR. MILTON J VANGUNDY MD
Emergency Medicine (Emergency Medical Services)
3 S 4TH AVE
MARSHALLTOWN, IA 50158
Marshall County (641) 754-5040

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Autumn Kelly's NPI number?

The NPI number for Autumn Kelly is 1205232634. It was assigned to this individual provider in the NPPES registry on November 12, 2014.

Where is Autumn Kelly located?

Autumn Kelly practices at 3 S 4th Ave Food And Nutrition Services, Marshalltown, IA 50158. The listed phone number is (641) 754-5271.

What is Autumn Kelly's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Autumn Kelly enrolled in Medicare?

Yes. Autumn Kelly is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Autumn Kelly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Autumn Kelly reassigns Medicare benefits to Upperline Healthcare, PC (Hoover, AL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Autumn Kelly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Autumn Kelly was last updated on November 12, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.