Active NPI
Kelly Barth, NP
- Pediatric Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1013360213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 23047
- Practice address
- 1880 Century Park E
Suite 425
Los Angeles, CA 90067-1600 - Phone
- (310) 248-4015
- NPI assigned
- Jul 22, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 23047 | CA | Primary |
Addresses
Primary practice location
1880 Century Park E
Suite 425
Los Angeles, CA 90067-1600
Mailing address
11600 Montana Ave
Apt 109
Los Angeles, CA 90049-4664
Phone (720) 261-8657
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23047 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469145600000",
"number": "1013360213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11600 MONTANA AVE",
"address_2": "APT 109",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900494664",
"telephone_number": "720-261-8657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1880 CENTURY PARK E",
"address_2": "SUITE 425",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900671600",
"telephone_number": "310-248-4015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARTH",
"first_name": "KELLY",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-22",
"last_updated": "2016-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CA",
"license": "23047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.