Active NPI
Libby Kelly, RN
- Psychiatric/Mental Health Registered Nurse
- Cullman, AL
National Provider Identifier
1376957100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Registered Nurse
- License
- 1-093300
- Practice address
- 1909 Commerce Ave
Cullman, AL 35055-6151 - Phone
- (256) 734-4688
- NPI assigned
- Jun 19, 2014
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 1-093300 | AL | Primary |
Addresses
Primary practice location
1909 Commerce Ave
Cullman, AL 35055-6151
Mailing address
1909 Commerce Ave
Cullman, AL 35055-6151
Phone (256) 734-4688
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 330000025 | Medicaid | AL |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-093300 | AL | MD | Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403136000000",
"number": "1376957100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1909 COMMERCE AVE",
"city": "CULLMAN",
"state": "AL",
"postal_code": "350556151",
"telephone_number": "256-734-4688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1909 COMMERCE AVE",
"city": "CULLMAN",
"state": "AL",
"postal_code": "350556151",
"telephone_number": "256-734-4688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "LIBBY",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-19",
"last_updated": "2014-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "AL",
"license": "1-093300",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "330000025",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cullman, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.