Kelly Ann Chaddha

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

P01191800 Issued in NJ

Practice address

119 Red Hill Rd
Middletown, NJ 07748-2405

Phone

(201) 618-8993

NPI assigned

Jan 13, 2022

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

Other names 1

• Miss Kelly Ann Chaddha Former name

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Tranquil Path Psychiatry LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Middletown, NJ
  • NPI 1487521753
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1642032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1508517210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 RED HILL RD",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077482405",
            "telephone_number": "201-618-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 RED HILL RD",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077482405",
            "telephone_number": "201-618-8993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHADDHA",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-13",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "P01191800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "CHADDHA",
            "middle_name": "ANN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Carle, CRNA
• Christina Casini, OT
• Michael Castellano
• Deirdre Cella
• Kate Alaine Chaballa, CPHT
• Wendy W Chan, RPH
• Yogesh H Chandrani, PHARMACIST
• Agueda Janine Chasco, HC
• Chece Psychological, LLC
• Stephen David Chece, PHD

• Primary Care Nurse Practitioner in Middletown, NJ
• Providers in Middletown, NJ by specialty
• Primary Care Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; 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.