Active NPI
Dara Kelly
- Audiologist
- Albany, NY
National Provider Identifier
1386010056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 002613-1
- Practice address
- 400 Patroon Creek Blvd
Suite 205
Albany, NY 12206-5013 - Phone
- (518) 701-2000
- Fax
- (518) 701-2020
- NPI assigned
- Aug 18, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 002613-1 | NY | Primary |
Addresses
Primary practice location
400 Patroon Creek Blvd
Suite 205
Albany, NY 12206-5013
Mailing address
414 Maple Ave
Ste 800
Saratoga Springs, NY 12866-5556
Phone (518) 584-0578
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002613 | NY | MD | Behavioral Analyst |
| 002613-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473897600000",
"number": "1386010056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "414 MAPLE AVE",
"address_2": "STE 800",
"city": "SARATOGA SPRINGS",
"state": "NY",
"postal_code": "128665556",
"telephone_number": "518-584-0578",
"fax_number": "518-584-2568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 PATROON CREEK BLVD",
"address_2": "SUITE 205",
"city": "ALBANY",
"state": "NY",
"postal_code": "122065013",
"telephone_number": "518-701-2000",
"fax_number": "518-701-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "DARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-18",
"last_updated": "2016-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NY",
"license": "002613-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.