Jennifer Jo Kelly, RN, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

COA.08014-NP Issued in OH

Practice address

3333 Burnet Ave
ML 5006 Diabetes Clinic
Cincinnati, OH 45229

Phone

(513) 636-9079

Fax

(513) 636-7576

NPI assigned

May 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Jennifer Jo Price Former name

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Children'S Hospital Medical Center

  • Pediatrics Physician
  • Cincinnati, OH
  • NPI 1609915784

  Nurse Practitioner

  Medicare reassignment NPD
• Robin T Cotton, MD, Inc

  • Pediatric Otolaryngology Physician
  • Cincinnati, OH
  • NPI 1003100322
  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348963200000",
    "number": "1063460558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "ML 5021",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293039",
            "telephone_number": "513-636-9079",
            "fax_number": "513-636-7576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "ML 5006 DIABETES CLINIC",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45229",
            "telephone_number": "513-636-9079",
            "fax_number": "513-636-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JENNIFER",
        "middle_name": "JO",
        "credential": "RN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2012-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.08014-NP",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "COA.08014-NP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2656951",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "PRICE",
            "middle_name": "JO",
            "credential": "RN, CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Margaret Ann Kelly, MD
• Emily Katherine Kelly, PA-C
• Jackson Patrick Kelly, MD
• Jaelyn Kelly
• James D Kelly, PH.D
• Jerome J Kelly, M.D.
• Joe Kelly
• Jonathan Randall Kelly
• Juleisa Karole Kelly
• Kaitlyn Jo Kelly, MD

• Nurse Practitioner in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.