Pamela Stauffer Kelly

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

626845-1 Issued in NY

Practice address

569 58TH St
Apartment 1R
Brooklyn, NY 11220-3847

Phone

(509) 668-3978

NPI assigned

Apr 21, 2010

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271808000000",
    "number": "1124345897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "569 58TH ST",
            "address_2": "APARTMENT 1R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203847",
            "telephone_number": "509-668-3978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "569 58TH ST",
            "address_2": "APARTMENT 1R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203847",
            "telephone_number": "509-668-3978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "PAMELA",
        "middle_name": "STAUFFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-21",
        "last_updated": "2010-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "626845-1",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "00103209",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Kelly, PT, DPT
• Kaitlyn E. Kelly, OTR/L
• Letitia Kelly, RN
• Lydia Ester Kelly
• Marlene Kelly
• Paul J Kelly, MD
• Peta Kelly
• Richard Kelly, RN
• Sarah K Kelly, MSW, LCSW-R
• Sean C Kelly, MD

• Registered Nurse in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2010; 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.