Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelli Jean Penrose, PA, ATC

Individual provider Athletic Trainer · NPI 1740435551

Kelli Jean Penrose, PA, ATC is a Physician Assistant in Sartell, Minnesota. Qualified in 2008, 18 years ago. Practices with St Cloud Orthopedic Associates Ltd, a 44-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
18
Licensed in
MN
In the registry since
2008
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

1901 Connecticut Ave S
Sartell, MN 56377-2554
Phone: (320) 259-4100
Fax: (320) 259-8044
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3315 Roosevelt Rd Ste 200b, Saint Cloud, MN 56301-9687 — (320) 259-4100

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (MN)
Athletic Trainer Taxonomy 2255A2300X (MN)

Record details

NPI number1740435551
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA , ATC
Sole proprietorNo
NPI enumeratedNovember 20, 2008
Last updated in NPPESMay 20, 2020
Certification dateMay 20, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice St Cloud Orthopedic Associates Ltd — 44 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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