Kellie Ann Connelly, RETAIL PROVIDER

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Practice address

798 Meadowdale Rd
Altamont, NY 12009-4710

Phone

(518) 858-8129

Fax

(518) 861-6840

NPI assigned

Feb 19, 2021

Reactivated

Sep 12, 2022

Sex

Female

Sole proprietor

Yes

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.

• Compression Well-Being, LLC

  • Durable Medical Equipment & Medical Supplies
  • Altamont, NY
  • NPI 1013613298
  NPD Authorized official Durable Medical Equipment & Medical Supplies

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 12, 2022.

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1104419209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "798 MEADOWDALE RD",
            "city": "ALTAMONT",
            "state": "NY",
            "postal_code": "120094710",
            "telephone_number": "518-858-8129",
            "fax_number": "518-861-6840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "798 MEADOWDALE RD",
            "city": "ALTAMONT",
            "state": "NY",
            "postal_code": "120094710",
            "telephone_number": "518-858-8129",
            "fax_number": "518-861-6840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "KELLIE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "RETAIL PROVIDER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-19",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "deactivation_date": "2022-08-17",
        "reactivation_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Clements
• Cobb Memorial School
• Compression Well-Being, LLC
• Erica Anne Conery, RN, BSN
• Peter William Conery, LPN
• Emma Cranston, LMHC
• Heidi J Cutler, LCSW-R
• John Michael Darbyshire
• Amanda Debarr, DPT
• Ramona Sue Decker, FNP

• All providers in Altamont, NY
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.