Theresa A Kelly, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN298133L Issued in PA

Practice address

601 Park St
Honesdale, PA 18431-1445

Phone

(570) 647-4381

NPI assigned

Mar 20, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

360 Anesthesia PLLCGroup PAC ID 5991184863, 112 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wilkes-Barre General Hospital Hospital, Wilkes-Barre, PA, CCN 390137

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• 360 Anesthesia PLLC

  • Anesthesiology Physician
  • Wilkes Barre, PA
  • NPI 1811637366

  Nurse Anesthetist, Certified Registered, PA

  Medicare reassignment Care Compare group NPD
• Evangelical Medical Services Organization

  • Surgery Physician
  • Lewisburg, PA
  • NPI 1205928967

  PA

  Medicare reassignment NPD
• Gastrointestinal Consultants of Nepa

  • Gastroenterology Physician
  • Scranton, PA
  • NPI 1912905605

  PA

  Medicare reassignment NPD
• Evangelical Medical Services Organization

  • Emergency Medicine Physician
  • Lewisburg, PA
  • NPI 1073613345
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Wilkes Barre Hospital Company LLC

  • Clinic/Center
  • Wilkes Barre, PA
  • NPI 1053554378

  Hospital

  Care Compare affiliation
• Wilkes Barre Hospital Company LLC

  • General Acute Care Hospital
  • Wilkes Barre, PA
  • NPI 1255585303

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1003087776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 49",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152300049",
            "telephone_number": "570-647-4381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 PARK ST",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184311445",
            "telephone_number": "570-647-4381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "THERESA",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-20",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN298133L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00952243",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walter J Kaniefski, MD
• David B Kaplan, M.D.
• David C Kaplan, MD
• Karen Sue Kay, PHARMACIST
• Margaret L Kellogg, CRNP
• Kidspeace Children'S Hospital, Inc.
• Kidspeace National Centers Inc
• Kidspeace National Centers Inc
• Kimble Lactation Support
• Brittany N Kimble, RN IBCLC

• All providers in Honesdale, PA
• Certified Registered Nurse Anesthetist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.