Kelly O'Connell, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

0024173788 Issued in VA

Practice address

1204 W Main St
5TH Floor
Charlottesville, VA 22903-2824

Phone

(800) 362-2203

Fax

(434) 243-5204

NPI assigned

Aug 29, 2016

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472428800000",
    "number": "1508312612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 W MAIN ST",
            "address_2": "5TH FLOOR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229032824",
            "telephone_number": "800-362-2203",
            "fax_number": "434-243-5204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "KELLY",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-29",
        "last_updated": "2016-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024173788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nutrilux, LLC
• Divine Chibuzor Nwafor, MDPHD
• Kelsey Conlan O'Boyle, M.ED., CCC-SLP
• Joseph Gorman O'Brien Jr., MD
• Catherine Michele O'Connell, LPC
• Adam O'Connor, MD
• Colleen Marie McKenna O'Connor, M.D.
• Robert E. O'Connor, M.D.
• Stephen S O'Connor, PHD
• Emily T O'Gorman, PHD

• Pediatric Nurse Practitioner in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Pediatric Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.