Individual provider Active NPI

Lori M Kelley, CNM, MS

  • Advanced Practice Midwife
  • Newport, RI
National Provider Identifier
1588833941
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
CNM00084 Issued in RI
Practice address
20 Powel Avenue
Newport, RI 02840
Phone
(401) 848-5556
Fax
(401) 519-2994
NPI assigned
Feb 29, 2008
Last updated
Jul 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X CNM00084 RI Primary

Addresses

Primary practice location

20 Powel Avenue
Newport, RI 02840

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4541

Other practice location 1

11 Friendship St
Newport, RI 02840-2209
Phone (401) 846-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080415000009 RI Practitioner - Certified Nurse Midwife (CNM) 4284711367 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Master of Science

State licenses

LicenseStateTypeSpecialty
CNM00084RIMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Sep 11, 2023 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Sep 11, 2023 Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

11 Friendship St
Newport, RI 02840
Phone (401) 845-1110

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1588833941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 POWEL AVENUE",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "02840",
            "telephone_number": "401-848-5556",
            "fax_number": "401-519-2994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Friendship St",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "RI",
            "postal_code": "028402209",
            "country_code": "US",
            "telephone_number": "401-846-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "LORI",
        "middle_name": "M",
        "credential": "CNM, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-29",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "RI",
            "license": "CNM00084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, RI

Sources for this page

Verify at the official NPI Registry.