Individual provider Active NPI

Maureen M Kelly, NP

  • Nurse Practitioner
  • Chapel Hill, NC
National Provider Identifier
1043358344
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
300187 Issued in NC
Practice address
101 Manning Dr
Chapel Hill, NC 27599-0001
Phone
(919) 966-8596
Fax
(919) 843-5515
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 300187 NC Primary

Addresses

Primary practice location

101 Manning Dr
Chapel Hill, NC 27599-0001

Mailing address

143 W Franklin St
Chapel Hill, NC 27516-2539
Phone (919) 966-8596

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160810001464 NC Practitioner - Nurse Practitioner 9133413370 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
300187NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina at Chapel Hill CurrentSince May 17, 2016 Accepting new patients
Park Ophthalmology Past Accepting new patients

Locations

6013 Farrington Rd
Ste 201
Chapel Hill, NC 27517
Phone (984) 974-1401

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

2801 Blue Ridge Rd
Raleigh, NC 27607
Phone (984) 215-6435

Interoperability endpoints

  • Direct secure messaging: mkelly31476@direct.unc.nchie.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043358344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 W FRANKLIN ST",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275162539",
            "telephone_number": "919-966-8596",
            "fax_number": "919-843-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MANNING DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275990001",
            "telephone_number": "919-966-8596",
            "fax_number": "919-843-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MAUREEN",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "300187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.