Individual provider Active NPI

Kelly H Cao

  • Internist Chiropractor
  • Worcester, MA
National Provider Identifier
1265575286
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internist ChiropractorTaxonomy code 111NI0900X
License
2627 Issued in MA
Practice address
364 Burncoat St
Worcester, MA 01606-3129
Phone
(508) 752-5150
NPI assigned
Feb 15, 2007
Last updated
Jan 10, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internist Chiropractor 111NI0900X 2627 MA Primary

Addresses

Primary practice location

364 Burncoat St
Worcester, MA 01606-3129

Mailing address

364 Burncoat St
Worcester, MA 01606-3129
Phone (508) 752-5150

Other identifiers 1

IdentifierTypeStateIssuer
1601148MedicaidMA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2627MAMDRegistered Dietitian

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1265575286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 BURNCOAT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016063129",
            "telephone_number": "508-752-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 BURNCOAT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016063129",
            "telephone_number": "508-752-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAO",
        "first_name": "KELLY",
        "middle_name": "H",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NI0900X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Internist",
            "state": "MA",
            "license": "2627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1601148",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; 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.