Heidi Lea Kelly, FNP-BC, MSN, MPH, RN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024172403 Issued in VA

Practice address

1300 E 23Rd St
Chattanooga, TN 37404-5701

Phone

(423) 760-4000

NPI assigned

Jun 3, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Other names 1

• Heidi Lea Swan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: heidi.kelly.1@26609.direct.athenahealth.com

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.

• OB Medicos, PLLC

  • Specialist
  • Chattanooga, TN
  • NPI 1548664840
  NPD
• Clinica Sonrisas LLC

  • Pediatric Dentistry
  • Chattanooga, TN
  • NPI 1275315269
  NPD (past)

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1134532567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 E 23RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374045701",
            "telephone_number": "423-760-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E 23RD ST",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374045701",
            "telephone_number": "423-760-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "HEIDI",
        "middle_name": "LEA",
        "credential": "FNP-BC, MSN, MPH, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-03",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR17016400",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001256235",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "671570",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "233514",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "24989",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024172403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "SWAN",
            "middle_name": "LEA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ana L Kelly, PT, DPT
• Anna Turner Kelly
• Cameron Rose Kelly
• Chrystle M Kelly, OT/L
• Delbert R Kelly, D.D.S
• Jessie Kelly, LMFT
• John Thomas Kelly, P.T.
• Leisha Kae Kelly, LPN
• Robin K Kelly, RPH
• William Hugh Kelly

• Family Nurse Practitioner in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; 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.