Kelley Simon Kelly, APN

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

AO1555ANP Issued in AR

Practice address

4300 W 7TH St
Little Rock, AR 72205-5446

Phone

(501) 257-6854

Fax

(501) 257-5099

NPI assigned

Mar 22, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033235809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 SHERWOOD AVE",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721205804",
            "telephone_number": "501-257-6854",
            "fax_number": "501-257-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W 7TH ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055446",
            "telephone_number": "501-257-6854",
            "fax_number": "501-257-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KELLEY",
        "middle_name": "SIMON",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "AO1555ANP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeromy Kelley
• Brandon M. Kelly, MD
• Hilary Kelly, LCSW
• Karey Lynn Kelly, CRNA
• Kathryn Grace Kelly
• Mary Kelly
• Matthew Scott Kelly, M.D., M.P.H.
• Natisha Kelly, HEALTH COACH
• Shakima Laneka Kelly, QBHP
• Crystal Kellybrew

• Acute Care Nurse Practitioner in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Acute Care Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.