Individual provider Active NPI

Jennifer Kelly, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1215677216
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11018854 Issued in FL
Practice address
500 W Monroe St Ste 1300
Chicago, IL 60661-3704
Phone
(877) 751-5783
NPI assigned
Mar 30, 2022
Last updated
Sep 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11018854 FL Primary

Addresses

Primary practice location

500 W Monroe St Ste 1300
Chicago, IL 60661-3704

Mailing address

2601 Manatee Ave W Ste E
Bradenton, FL 34205-4942
Phone (941) 744-0040

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
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
APRN11018854FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1215677216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 MANATEE AVE W STE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342054942",
            "telephone_number": "941-744-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W MONROE ST STE 1300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606613704",
            "telephone_number": "877-751-5783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JENNIFER",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-30",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11018854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.

Verify at the official NPI Registry.