Individual provider Active NPI

Kelly Reilly-Furlong, RN

  • Registered Nurse
  • Charlotte, ME
National Provider Identifier
1003393364
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN36411 Issued in ME
Practice address
88 Damon Ridge Rd
Charlotte, ME 04666-6703
Phone
(207) 214-9255
NPI assigned
Jul 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN36411 ME Primary

Addresses

Primary practice location

88 Damon Ridge Rd
Charlotte, ME 04666-6703

Mailing address

88 Damon Ridge Rd
Charlotte, ME 04666-6703
Phone (207) 214-9255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN36411MEMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1003393364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 DAMON RIDGE RD",
            "city": "CHARLOTTE",
            "state": "ME",
            "postal_code": "046666703",
            "telephone_number": "207-214-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 DAMON RIDGE RD",
            "city": "CHARLOTTE",
            "state": "ME",
            "postal_code": "046666703",
            "telephone_number": "207-214-9255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY-FURLONG",
        "first_name": "KELLY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ME",
            "license": "RN36411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.