Kelly W. Bates, DNP,APN-CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.018159 Issued in IL

Practice address

2150 Pennsylvania Ave NW
Washington, DC 20037-3201

Phone

(301) 467-6711

NPI assigned

Oct 31, 2018

Last updated

Aug 30, 2021By 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

Enrolled in DC

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medical Faculty Associates, Inc

  • Anesthesiology Physician
  • Washington, DC
  • NPI 1417990581
  Medicare reassignment NPD
• Endeavor Health Clinical Operations

  dba Endeavor Health Highland Park Hospital

  • Psychiatric Hospital Unit
  • Highland Park, IL
  • NPI 1770527236
  NPD (past)

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1558838102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 PENNSYLVANIA AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200373201",
            "telephone_number": "301-467-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 PENNSYLVANIA AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200373201",
            "telephone_number": "301-467-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATES",
        "first_name": "KELLY",
        "middle_name": "W.",
        "credential": "DNP,APN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-31",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.018159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Letee Bates
• Alberta Bates
• Angel Deshawn Bates
• Clarence Bates
• Jerome Bates
• Mabel Bates
• Renee Bates
• Harleen Kaur Bath, PA-C
• Seritta Bathanazas
• Sapna Batheja, RD LDN

• Family Nurse Practitioner in Washington, DC
• Providers in Washington, DC by specialty
• Family Nurse Practitioner in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; 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.