Mary A Kelly, NP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

306256 Issued in NY

Practice address

2000 N Village Ave
Suite 108
Rockville Centre, NY 11570-1078

Phone

(516) 678-1444

Fax

(516) 678-1023

NPI assigned

Jan 16, 2013

Last updated

Jan 16, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1358294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1417294018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 N VILLAGE AVE",
            "address_2": "SUITE 108",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115701078",
            "telephone_number": "516-678-1444",
            "fax_number": "516-678-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N VILLAGE AVE",
            "address_2": "SUITE 108",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115701078",
            "telephone_number": "516-678-1444",
            "fax_number": "516-678-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MARY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-16",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "306256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Keene
• Keith H Hasday DDS PC (Rockville Centre for Dentistry)
• Keith Woythaler Psychologist, P.C.
• Maura Renee Kelly-Magliaro, OTR/L
• Janice Kelly, CSW
• Samantha A. Kelly, CRNA
• Heidi Lee Kenny
• Keri Mica LCSW PC
• Jay A Kerner, DPM
• Howard N. Kessler, D.P.M.

• Adult Health Nurse Practitioner in Rockville Centre, NY
• Providers in Rockville Centre, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; 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.