Individual provider Active NPI

Janet E Kelley, CRNP

  • Nurse Practitioner
  • Erie, PA
National Provider Identifier
1073512810
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
VP003650C Issued in PA
Practice address
5035 Peach St
Erie, PA 16509-2013
Phone
(814) 480-7789
Fax
(814) 480-7790
NPI assigned
Jul 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP126300 TX
Nurse Practitioner 363L00000X VP003650C PA Primary

Addresses

Primary practice location

5035 Peach St
Erie, PA 16509-2013

Mailing address

11990 N Central Expy
Dallas, TX 75243-3714
Phone (469) 924-3262

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
I20060504000604 PA Practitioner - Nurse Practitioner 9032129093 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Group practices
Ars Treatment Centers PCGroup PAC ID 0042568131, 107 clinicians

Practice addresses (Care Compare)

15957 Conneaut Lake Rd
Suite 6
Meadville, PA 16335-4763
Phone (800) 805-6989

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP126300TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ars Treatment Centers, P.C. CurrentSince Jul 1, 2022 Accepting new patients
Trilogy Wellness, LLC CurrentSince Apr 19, 2022 Accepting new patients
Ars Treatment Centers, P.C. CurrentSince Jul 1, 2022 Accepting new patients
OB-GYN Associates of Erie, PC CurrentSince Mar 1, 2023 Accepting new patients

Locations

220 S Main St
Ste A
Butler, PA 16001

624 S 5th Ave
Clarion, PA 16214

100 Peach St
Ste 300
Erie, PA 16507
Phone (814) 459-1851

1611 Peach St
Ste 315
Erie, PA 16501

5035 Peach St
Erie, PA 16509
Phone (814) 480-7789

207 Martin Luther King Jr Blvd
Farrell, PA 16121
Phone (724) 402-3234

150 Prospect Ave
Ste 303
Franklin, PA 16323

17 6th Ave
Greenville, PA 16125
Phone (412) 588-2600

300 Hansen Plz
Lyndora, PA 16045
Phone (724) 256-9424

15957 Conneaut Lake Rd
Ste 6
Meadville, PA 16335

2317 E Westmoreland St
Philadelphia, PA 19134
Phone (215) 291-3115

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.

NPI Registry JSON

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1073512810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11990 N CENTRAL EXPY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433714",
            "telephone_number": "469-924-3262",
            "fax_number": "469-624-3426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5035 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092013",
            "telephone_number": "814-480-7789",
            "fax_number": "814-480-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "JANET",
        "middle_name": "E",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-14",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP126300",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "VP003650C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.