Individual provider Active NPI

Lisa Ann Kelley, LPN, A.A.S.

  • Licensed Practical Nurse
  • Kitts Hill, OH
National Provider Identifier
1407788664
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
2035165 Issued in KY
Practice address
7973 State Route 141
Kitts Hill, OH 45645-8655
Phone
(740) 550-3299
NPI assigned
Jun 2, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 2035165 KY Primary

Addresses

Primary practice location

7973 State Route 141
Kitts Hill, OH 45645-8655

Mailing address

7973 State Route 141
Kitts Hill, OH 45645-8655

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
Associate of Applied Science

State licenses

LicenseStateTypeSpecialty
2035165KYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1780358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1407788664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7973 STATE ROUTE 141",
            "city": "KITTS HILL",
            "state": "OH",
            "postal_code": "456458655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7973 STATE ROUTE 141",
            "city": "KITTS HILL",
            "state": "OH",
            "postal_code": "456458655",
            "telephone_number": "740-550-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LPN, A.A.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-06-02",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "KY",
            "license": "2035165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kitts Hill, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; 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.