Individual provider Active NPI

Kelly N Jones, CRNP

  • Adult Health Nurse Practitioner
  • Paoli, PA
National Provider Identifier
1063901577
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP018764 Issued in PA
Practice address
2 Industrial Blvd Ste 200
Paoli, PA 19301-1648
Phone
(610) 647-2400
Fax
(610) 647-3902
NPI assigned
May 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SP018764 PA
Adult Health Nurse Practitioner 363LA2200X SP018764 PA Primary

Addresses

Primary practice location

2 Industrial Blvd Ste 200
Paoli, PA 19301-1648

Mailing address

207 N Broad St FL 3
Philadelphia, PA 19107-1500
Phone (267) 479-4142

Other identifiers 1

IdentifierTypeStateIssuer
1036726900004MedicaidPA

Other names 1

  • Kelly Modes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20181231000663 PA Practitioner - Nurse Practitioner 7214272871 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cardiology Consultants of Philadelphia PCGroup PAC ID 5294620746, 154 clinicians

Practice addresses (Care Compare)

1703 S Broad St
Suite 300
Philadelphia, PA 19148-1536
Phone (215) 463-5333

Hospital & facility affiliations

  • Paoli Hospital Hospital, Paoli, PA, CCN 390153
  • Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Chester County Hospital Hospital, West Chester, PA, CCN 390179
  • Riddle Memorial Hospital Hospital, Media, PA, CCN 390222

Merit-based Incentive Payment System (MIPS)

Final score
89.23 of 100Reported as group
Quality
86.8
Promoting interoperability
100
Improvement activities
40
Cost
77.29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP018764PAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physician Services, PC CurrentSince Oct 8, 2018 Accepting new patients
Alliance Physician Services, PC Current Accepting new patients
Alliance Physician Services, PC /Dba Midlantic Urology CurrentSince Oct 8, 2018 Accepting new patients
Cardiology Consultants of Philadelphia, P.C. CurrentSince Jan 6, 2020 Accepting new patients

Locations

495 Thomas Jones Way
Ste 200
Exton, PA 19341
Phone (610) 280-7828

211 S Gulph Rd
Ste 200
Kng of Prussa, PA 19406
Phone (610) 382-5910

255 W Lancaster Ave
Ste 234
Paoli, PA 19301
Phone (610) 647-4260

2 Industrial Blvd
Ste 200
Paoli, PA 19301
Phone (610) 647-4260

207 N Broad St
Fl 3
Philadelphia, PA 19107
Phone (215) 361-5020

1703 S Broad St
Ste 300
Philadelphia, PA 19148
Phone (215) 462-7100

915 Old Fern Hill Rd
Ste 202
West Chester, PA 19380
Phone (610) 579-3577

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1063901577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 N BROAD ST FL 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071500",
            "telephone_number": "267-479-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 INDUSTRIAL BLVD STE 200",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011648",
            "telephone_number": "610-647-2400",
            "fax_number": "610-647-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "KELLY",
        "middle_name": "N",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-09",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP018764",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP018764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1036726900004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MODES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Paoli, PA

Sources for this page

Verify at the official NPI Registry.