KELLY ELIZABETH KING PHD, LP
NPI 1679840391
Psychologist - Clinical in Minneapolis, MN
About Kelly Elizabeth King Phd, Lp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY ELIZABETH KING PHD, LP (NPI 1679840391) is an individual clinical provider in Minneapolis, Minnesota, licensed in Minnesota (LP 5429) and active in the NPI registry since November 2011. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kelly Elizabeth King Phd, Lp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
5Medicare enrollment records show Kelly King reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Minneapolis, MN 55454
- Reassigned Medicare billing, Minnesota enrollment
- Medicare enrollment name: University Of Minnesota Physicians
- 1,453 clinicians in this Medicare group
Minneapolis, MN 55454
- Reassigned Medicare billing, Minnesota enrollment
- 3,633 clinicians in this Medicare group
Minneapolis, MN 55454
- Reassigned Medicare billing, Minnesota enrollment
- 4,038 clinicians in this Medicare group
Minneapolis, MN 55454
- Reassigned Medicare billing, Minnesota enrollment
- 2,373 clinicians in this Medicare group
Minneapolis, MN 55455
- Reassigned Medicare billing, Minnesota enrollment
- 1,662 clinicians in this Medicare group
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 55454 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
MINNEAPOLIS, MN 55454
MINNEAPOLIS, MN 55454
MINNEAPOLIS, MN 55454
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 Kelly King's NPI number?
The NPI number for Kelly King is 1679840391. It was assigned to this individual provider in the NPPES registry on November 23, 2011.
Where is Kelly King located?
Kelly King practices at 2512 S 7th St, Minneapolis, MN 55454. The listed phone number is (612) 626-6777.
What is Kelly King's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Kelly King enrolled in Medicare?
Yes. Kelly King is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Kelly King's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly King reassigns Medicare benefits to 5 organizations: University Of Minnesota Pediatric Dental Clinic (Minneapolis, MN), Fairview Express Care (Minneapolis, MN), Fairview Health Services (Minneapolis, MN), Fairview Specialty Services (Minneapolis, MN) and University Of Minnesota Health Clinics And Surgery Center Inc (Minneapolis, MN). Each 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 Kelly King's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelly King accept?
Health plans from Sanford Health Plan list Kelly King as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Kelly King was last updated on November 23, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Kelly Elizabeth King, PHD, LP · NPI 1679840391
Clinical provider in Minneapolis, Minnesota. Individual provider, active in the CMS NPPES registry since November 23, 2011.
## Identity
- **NPI:** 1679840391 (Entity type: Individual)
- **Enumerated:** November 23, 2011
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** LP 5429 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 2512 S 7TH ST, Minneapolis, MN 55454-1404
- **Phone:** (612) 626-6777 · **Fax:** (612) 624-1446
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): University Of Minnesota Pediatric Dental Clinic (NPI 1992075287, Minneapolis, MN); Fairview Express Care (NPI 1841428745, Minneapolis, MN); Fairview Health Services (NPI 1316008212, Minneapolis, MN); Fairview Specialty Services (NPI 1043199334, Minneapolis, MN); University Of Minnesota Health Clinics And Surgery Center Inc (NPI 1003485004, Minneapolis, MN) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 23, 2011
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Source: [NPI Profile](https://npiprofile.com/npi/1679840391) · Data from the CMS NPPES public registry.