Individual provider Active NPI

Kelly Callahan, CRNA

  • Certified Registered Nurse Anesthetist
  • Bryn Mawr, PA
National Provider Identifier
1306934070
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NJ00228400 Issued in NJ
Practice address
130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone
(610) 526-3000
NPI assigned
Oct 10, 2006
Last updated
Dec 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 073193 PA
Certified Registered Nurse Anesthetist 367500000X 26NJ00228400 NJ Primary

Addresses

Primary practice location

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121

Mailing address

PO Box 95000-2130
Philadelphia, PA 19195-2130
Phone (201) 804-2800

Other practice location 1

100 Bowman Dr Fl 1
Voorhees, NJ 08043-9612
Phone (856) 988-6260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071011000130 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 0840255485 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 247-7260

3242 Route 206
Bordentown, NJ 08505-4517

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.15 of 100Reported as group
Quality
62.28
Promoting interoperability
100
Improvement activities
40
Cost
74.89

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
073193PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA CurrentSince Oct 2, 2023 Accepting new patients
Shrewsbury Ambulatory Anesthesia LLC CurrentSince Jun 1, 2025 Accepting new patients
Society Hill Anesthesia Consultants of New Jersey, PC CurrentSince Jul 1, 2022 Accepting new patients
West Jersey Anesthesia Associate PA CurrentSince Jul 22, 2019 Accepting new patients
Virtua Medical Group, PA Nurse Anesthetist, Certified Registered Current Accepting new patients
Virtua Medical Group, PA CurrentSince Oct 2, 2023 Accepting new patients
Society Hill Anesthesia Consultants, PC Past Accepting new patients
Atlantic Coast Gastroenterology Associates Past Accepting new patients

Locations

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

408 Route 70 E
Cherry Hill, NJ 08034
Phone (267) 322-7700

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

655 Shrewsbury Ave
Shrewsbury, NJ 07702
Phone (732) 450-6000

405 Bethel Rd
Somers Point, NJ 08244
Phone (609) 601-7600

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

100 Bowman Dr
Fl 1
Voorhees, NJ 08043
Phone (856) 247-2645

1000 White Horse Rd
Ste 204
Voorhees, NJ 08043
Phone (856) 309-5808

200 Bowman Dr
Ste D160
Voorhees, NJ 08043
Phone (856) 247-3000

Interoperability endpoints

  • Direct secure messaging: kcallahan18011@directvirtua.org

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1306934070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000-2130",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191952130",
            "telephone_number": "201-804-2800",
            "fax_number": "201-804-8883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S BRYN MAWR AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103121",
            "telephone_number": "610-526-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Bowman Dr Fl 1",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439612",
            "country_code": "US",
            "telephone_number": "856-988-6260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "KELLY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "073193",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ00228400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.