Leslie R Kelly, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4902-33 Issued in WI

Practice address

30 Locust St
Northampton, MA 01060-2052

Phone

(413) 582-2441

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: leslie.kelly.p1@direct.fallonhealth.nextgenshare.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.

• Ipc Hospitalists of New England, P.C.

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1659555266

  Nurse Practitioner

  Medicare reassignment NPD
• American Advanced Practice Network, P.C.

  • Nurse Practitioner
  • Watertown, SD
  • NPI 1790244341

  MA

  Medicare reassignment NPD
• Ipc Hospitalists of New England PC

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1801330287

  Nurse Practitioner

  NPD

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1205946266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 LOCUST ST",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010602052",
            "telephone_number": "413-582-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 LOCUST ST",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010602052",
            "telephone_number": "413-582-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LESLIE",
        "middle_name": "R",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VT",
            "license": "101-0021171",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "4902-33",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "191800-30",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "238190",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCYCARE INSURANCE",
            "identifier": "KELLYLES",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205946266",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110102297A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1008712",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSWI",
            "identifier": "1205946266",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David James Keighley, RPH
• Elizabeth Coburn Keller, MS, LICSW
• Dwight Kelley
• Katherine E Kelly, FNP
• Kristen Kelly, M.D.
• Marguerite Ann Kelly, LICSW
• Matthew P Kelly, LMHC
• Wanda Lee Kelly
• Angel Marie Kennedy, MS, BCBA
• Nora Larson Kennedy

• Nurse Practitioner in Northampton, MA
• Providers in Northampton, MA by specialty
• Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.