Antoinette Lashawn Kelly

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

10289950 Issued in NY

Practice address

25 Wanda St
Rochester, NY 14621-2417

Phone

(585) 298-8122

NPI assigned

Apr 9, 2014

Last updated

Apr 9, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1295154086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WANDA ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146212417",
            "telephone_number": "585-298-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WANDA ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146212417",
            "telephone_number": "585-298-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ANTOINETTE",
        "middle_name": "LASHAWN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-09",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "10289950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Newby, Psy.D., PLLC
• D'Netra Kelly-Brooks, LPN
• Mary Shea Kelly-Buckley
• Sarah Jeanne Kelly-Pisciotti, PHARM.D.
• Andrew Kelly, MD
• Caitlin Patricia Brock Kelly, LMHC
• Conor Kelly, DPT
• Cynthia Catherine Kelly, LCSW
• Deborah B Kelly, RD
• Devin E Kelly, LMSW

• Licensed Practical Nurse in Rochester, NY
• Providers in Rochester, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; 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.