Active NPI
Kelly Michelle Kennelley, RD, LDN
- Registered Dietitian
- Erie, PA
National Provider Identifier
1083910012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN002326
- Practice address
- 100 Barber PL
Erie, PA 16507-1863 - Phone
- (814) 453-7661
- Fax
- (814) 874-5505
- NPI assigned
- Feb 9, 2011
- Last updated
- Feb 9, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DN002326 | PA | Primary |
Addresses
Primary practice location
100 Barber PL
Erie, PA 16507-1863
Mailing address
100 Barber PL
Erie, PA 16507-1863
Phone (814) 453-7661
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shriners Hospitals for Children | Current | Accepting new patients | |
| Shriners Hospitals for Children | Dietitian, Registered | Current | Accepting new patients |
| Christine Barr | Past | Accepting new patients | |
| Dr Gertrude a Barber Center Inc | Past | Accepting new patients |
Locations
1645 W 8th St
Erie, PA 16505
Phone (814) 875-8700
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/barberinstitute/r4/
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- NPI 1982971503
Dietitian, Registered
-
dba Shriners Children's Hawaii
- Clinic/Center
- Aiea, HI
- NPI 1568299857
-
- Social Worker
- Erie, PA
- NPI 1629748702
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297209600000",
"number": "1083910012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 BARBER PL",
"city": "ERIE",
"state": "PA",
"postal_code": "165071863",
"telephone_number": "814-453-7661",
"fax_number": "814-874-5505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 BARBER PL",
"city": "ERIE",
"state": "PA",
"postal_code": "165071863",
"telephone_number": "814-453-7661",
"fax_number": "814-874-5505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNELLEY",
"first_name": "KELLY",
"middle_name": "MICHELLE",
"credential": "RD, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-09",
"last_updated": "2011-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN002326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.