Alexandrea Catherine Kelly

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

1024508 Issued in TX

Practice address

1411 N Beckley Ave Ste 352
Dallas, TX 75203-1270

Phone

(214) 943-2249

Fax

(214) 943-8213

NPI assigned

Jan 5, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Alexandrea Catherine Billiu Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1134717127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 N BECKLEY AVE STE 352",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752031270",
            "telephone_number": "214-943-2249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 N BECKLEY AVE STE 352",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752031270",
            "telephone_number": "214-943-2249",
            "fax_number": "214-943-8213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ALEXANDREA",
        "middle_name": "CATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-05",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "861329",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1024508",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1024508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDREA",
            "last_name": "BILLIU",
            "middle_name": "CATHERINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lara Kellogg, DDS
• Zachary Kellum, DPT
• Kellvan J Cheng, DPM, PA
• Kelly Jameson, PHD
• Kelly L Wimberly MD PA
• Asya Rojae Kelly
• Aubrey Kelly, OTR
• Bryan Kelly, M.D.
• Carleushia Kelly, BSN,RN
• Christina Kelly

• Gerontology Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Gerontology Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.