Sherri Sue Kelly, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

231570-01 Issued in NY

Practice address

4214 Kelly LN
Burdett, NY 14818-9805

Phone

(607) 351-4265

NPI assigned

Aug 17, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Sherri Sue Kelly Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1477165017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 KELLY LN",
            "city": "BURDETT",
            "state": "NY",
            "postal_code": "148189805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4214 KELLY LN",
            "city": "BURDETT",
            "state": "NY",
            "postal_code": "148189805",
            "telephone_number": "607-351-4265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SHERRI",
        "middle_name": "SUE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "231570",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "231570-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERRI",
            "last_name": "KELLY",
            "middle_name": "SUE",
            "credential": "LPN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Licensed Practical Nurse in Burdett, NY
• Providers in Burdett, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.