Carolyn Ann Kelly, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

005298 Issued in CT

Practice address

11 Osborne St
Danbury, CT 06810-5918

Phone

(203) 739-7131

Fax

(203) 739-1554

NPI assigned

Mar 7, 2013

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 names 1

• Carolyn Waterbury Other name

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490313600000",
    "number": "1407197072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 OSBORNE ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106000",
            "telephone_number": "917-968-6543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 OSBORNE ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105918",
            "telephone_number": "203-739-7131",
            "fax_number": "203-739-1554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CAROLYN",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-07",
        "last_updated": "2017-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "005298",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F337508-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "WATERBURY",
            "credential": "APRN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Daniel R Kelleher, M.D.
• Andrew Keller, M.D.
• Barry Keller, MD
• Megan Mary Kelly Gilman, APRN
• Alyssa Kelly
• Elisabeth Grace Kelly, MFT, LMFT-A
• Sara Ann Kelman, L.C.S.W.
• Courtney E. Kennedy, P.A.
• Marci Lynn Kennen
• Jennifer Kennett-Powers

• Family Nurse Practitioner in Danbury, CT
• Providers in Danbury, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.