Kelly Jo McClellan, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN289417 Issued in PA

Practice address

3438 Route 764
Duncansville, PA 16635-7803

Phone

(814) 944-7000

NPI assigned

May 7, 2021

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Discovery House BC LLC

  dba Duncansville Comprehensive Treatment Center

  • Methadone Clinic
  • Duncansville, PA
  • NPI 1013141977
  NPD

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1497339345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14969 S EAGLE VALLEY RD",
            "city": "TYRONE",
            "state": "PA",
            "postal_code": "166862458",
            "telephone_number": "814-414-8589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3438 ROUTE 764",
            "city": "DUNCANSVILLE",
            "state": "PA",
            "postal_code": "166357803",
            "telephone_number": "814-944-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "KELLY",
        "middle_name": "JO",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-07",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "PA",
            "license": "PN289417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Anthony Maruca Jr., DENTIST
• Ann Elizabeth Matson-Logue, PT
• Jonathan Paul Mazur, DPT
• Beth McCahren, RN
• Lisa Rose McCarthy, PA-C
• Corlyn McConnell, CRNP, FNP-C,PMHNP-BC
• Elle McConnell, NP-C
• James Martin McConnell, RPH
• John McGowan
• Kimberly McIntosh

• Licensed Practical Nurse in Duncansville, PA
• Providers in Duncansville, PA by specialty
• Licensed Practical Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; 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.