Individual provider Active NPI

Jasmine Kelly

  • Licensed Practical Nurse
  • Elyria, OH
National Provider Identifier
1053222125
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
183864 Issued in OH
Practice address
174 Midway Blvd
Elyria, OH 44035-2786
Phone
(440) 723-8997
NPI assigned
Sep 16, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 183864 OH Primary

Addresses

Primary practice location

174 Midway Blvd
Elyria, OH 44035-2786

Mailing address

3312 Bosworth Rd
Cleveland, OH 44111-3607

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1789516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789516800000",
    "number": "1053222125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3312 BOSWORTH RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441113607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 MIDWAY BLVD",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440352786",
            "telephone_number": "440-723-8997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JASMINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-16",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "183864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.