Individual provider Active NPI

William Kelly, CRNA

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
National Provider Identifier
1306833637
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN318961L Issued in PA
Practice address
2301 S Broad St
Philadelphia, PA 19148-3542
Phone
(215) 952-9323
Fax
(215) 952-1246
NPI assigned
Oct 3, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN318961L PA Primary

Addresses

Primary practice location

2301 S Broad St
Philadelphia, PA 19148-3542

Mailing address

2112 Aqueduct Lane
Cherry Hill, NJ 08002
Phone (856) 952-7455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040217000513 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1254226426
I20040426000447 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 1254226426 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN318961LPAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ultracare Anesthesia Partners LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 22, 2017 Accepting new patients
New Jersey Healthcare Specialists PC CurrentSince Apr 11, 2016 Accepting new patients
South Jersey Anesthesia and Pain Physicians PC CurrentSince Jul 3, 2008 Accepting new patients
Virtua Medical Group, PA CurrentSince Jul 1, 2010 Accepting new patients
Methodist Associates in Healthcare, Inc Past Accepting new patients
Associates in Anesthesia, Inc. PastSince Mar 30, 2026 Accepting new patients
Associates in Anesthesia Past Accepting new patients
Regional Gastroenterology Associates of Lancaster, LTD. Past Accepting new patients
Bayhealth Medical Center, Inc Past Accepting new patients
Huntingdon Valley Anesthesia Associates Past Accepting new patients
Society Hill Anesthesia Consultants of New Jersey, PC Past Accepting new patients
Society Hill Anesthesia Consultants, PC Past Accepting new patients
James F Noone MD PC Past Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

901 W Main St
Freehold, NJ 07728
Phone (732) 294-2666

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

600 S White Horse Pike
Hammonton, NJ 08037
Phone (609) 561-6700

175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660

1140 Route 72 W
Stafford Township, NJ 08050
Phone (609) 978-2194

2835 S Delsea Dr
Vineland, NJ 08360
Phone (856) 696-0020

2 Van Buren Rd
Voorhees, NJ 08043
Phone (856) 770-0800

100 Bowman Dr
Voorhees, NJ 08043
Phone (856) 247-3000

509 N Broad St
Woodbury, NJ 08096
Phone (856) 686-5396

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0d26bd04-9128-4f58-8e6d-ffda5cd00f89/

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306833637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 AQUEDUCT LANE",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "08002",
            "telephone_number": "856-952-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191483542",
            "telephone_number": "215-952-9323",
            "fax_number": "215-952-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "WILLIAM",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN318961L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.