Sherry J Kelly, CNIM

Primary specialty

Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X

License

2671

Practice address

7112 Deer Ridge Rd
Fairview, TN 37062-8908

Phone

(309) 738-6481

NPI assigned

Dec 8, 2020

Last updated

Dec 8, 2020By 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)

Not enrolled

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

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1467058156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7112 DEER RIDGE RD",
            "city": "FAIRVIEW",
            "state": "TN",
            "postal_code": "370628908",
            "telephone_number": "309-738-6481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7112 DEER RIDGE RD",
            "city": "FAIRVIEW",
            "state": "TN",
            "postal_code": "370628908",
            "telephone_number": "309-738-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SHERRY",
        "middle_name": "J",
        "credential": "CNIM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-08",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": "2671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Electroneurodiagnostic Specialist/Technologist in Fairview, TN
• Providers in Fairview, TN by specialty
• Electroneurodiagnostic Specialist/Technologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; 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.