Samantha Caitlin Kelley

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

24559 Issued in TN

Practice address

3443 Dickerson Pike Ste 680
Nashville, TN 37207

Phone

(615) 865-3322

NPI assigned

Jun 21, 2018

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1265926208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523A W HOLLIS CHAPEL RD",
            "city": "PORTLAND",
            "state": "TN",
            "postal_code": "371485348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3443 DICKERSON PIKE STE 680",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37207",
            "telephone_number": "615-865-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "SAMANTHA",
        "middle_name": "CAITLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "TN",
            "license": "198215",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "24559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100550900",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q044832",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Sue Kelley, LCSW
• Lisa S Kelley, CRNA
• Mark Allen Kelley, CRNA
• Mary Campbell Kelley, CRNA
• Rosemary Helen Kelley, MD
• Shelby Rachelle Kelley, AGACNP
• Sherry L Kelley, CRNA
• Soibhan Kelley, MD
• Wendell Aaron Kelley, LPC
• Kelli a. Turner, DDS, PC

• Acute Care Nurse Practitioner in Nashville, TN
• Providers in Nashville, TN by specialty
• Acute Care Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; 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.