Active NPI
Jalisa Marie Kelly
- Home Health Aide
- Washington, DC
National Provider Identifier
1154016301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 00000
- Practice address
- 4001 S Capitol St SW Apt 129
Washington, DC 20032-1368 - Phone
- (202) 230-8644
- NPI assigned
- Apr 5, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 00000 | DC | Primary |
Addresses
Primary practice location
4001 S Capitol St SW Apt 129
Washington, DC 20032-1368
Mailing address
4001 S Capitol St SW Apt 207
Washington, DC 20032-1373
Phone (202) 491-7689
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00000 | DC | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680652800000",
"number": "1154016301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4001 S CAPITOL ST SW APT 207",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200321373",
"telephone_number": "202-491-7689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4001 S CAPITOL ST SW APT 129",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200321368",
"telephone_number": "202-230-8644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "JALISA",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-05",
"last_updated": "2023-04-05",
"certification_date": "2023-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "DC",
"license": "00000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.