Kelly Anne McDonough

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

491578041 Issued in NY

Practice address

8460 Parsons Blvd
Jamaica, NY 11432-2544

Phone

(718) 298-6161

NPI assigned

Jan 2, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Psychotherapuetic Evaluational Programs, Inc.

  • Early Intervention Provider Agency
  • Jamaica, NY
  • NPI 1346487402
  NPD (past)

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

{
    "created_epoch": "1230854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230854400000",
    "number": "1255577854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1796 BARD LN",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541506",
            "telephone_number": "516-589-2280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8460 PARSONS BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114322544",
            "telephone_number": "718-298-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONOUGH",
        "first_name": "KELLY",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-02",
        "last_updated": "2009-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1488232",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "491578041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wayne Charles McCormack, DC
• Shereene McDermott-Green, LMSW
• Daniel J McDermott, LCSW
• Dalton McDonald Jr.
• Michael A McDonald Jr., CCC-SLP, TSSLD
• Horace Bernard McDougan, CASAC-T
• Sommar Crystal McDowald, PA-C
• Lorena Faye McEachrane, L.P.N.
• Janece B McFadden, CASE MANAGER
• Dominiqua McFarlane, LPN

• Student in an Organized Health Care Education/Training Program in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2009; 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.