Regina Kelly-Hartshorne, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

SP016207 Issued in PA

Practice address

4201 Henry Ave
Philadelphia, PA 19144-5409

Phone

(215) 951-2986

Fax

(215) 951-6867

NPI assigned

Sep 6, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Camcare Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Camden, NJ
  • NPI 1952570426
  NPD (past)

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1306949250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 HENRY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191445409",
            "telephone_number": "215-951-2986",
            "fax_number": "215-951-6867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 HENRY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191445409",
            "telephone_number": "215-951-2986",
            "fax_number": "215-951-6867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY-HARTSHORNE",
        "first_name": "REGINA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NO/NN09043800",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP016207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6831109",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika Anaya Kellogg, LCSW
• Khadejah Kellogg
• Molly Kellogg, RD, LCSW
• Valerie L Kellom, M.S.S.
• Kelly Peters Counseling
• Amanda Grace Kelly, M.D.
• Andrea Kelly, M.D.
• Andrew James Kelly, DO
• Anne Kelly, LSW, M.ED
• Autumn Kelly, STUDENT

• Pediatric Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.