Active NPI
Brenda Kelly
- Community Health Registered Nurse
- Auburn, NY
National Provider Identifier
1376777490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Registered Nurse
- License
- 232041
- Practice address
- 8 Dill St
Auburn, NY 13021-3606 - Phone
- (315) 253-1456
- Fax
- (315) 253-1156
- NPI assigned
- May 4, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Registered Nurse | 163WC1500X | 232041 | NY | Primary |
Addresses
Primary practice location
8 Dill St
Auburn, NY 13021-3606
Mailing address
8 Dill St
Auburn, NY 13021-3606
Phone (315) 253-1456
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 232041 | NY | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241395200000",
"number": "1376777490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 DILL ST",
"city": "AUBURN",
"state": "NY",
"postal_code": "130213606",
"telephone_number": "315-253-1456",
"fax_number": "315-253-1156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 DILL ST",
"city": "AUBURN",
"state": "NY",
"postal_code": "130213606",
"telephone_number": "315-253-1456",
"fax_number": "315-253-1156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "BRENDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-04",
"last_updated": "2009-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "163WC1500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Community Health",
"state": "NY",
"license": "232041",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.