Phyllis D Kelliher, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN00058 Issued in RI

Practice address

825 Chalkstone Ave
Providence, RI 02908-4735

Phone

(401) 474-4288

Fax

(401) 434-5230

NPI assigned

May 13, 2013

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 RI, CT2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prospect Chartercare RWMC, LLCGroup PAC ID 0547492696, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Roger Williams Medical Center Hospital, Providence, RI, CCN 410004

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.

• Prospect Chartercare RWMC, LLC

  • Internal Medicine Physician
  • Providence, RI
  • NPI 1285059287
  Medicare reassignment Care Compare group NPD
• Chartercare Roger Williams Medical Center

  • Internal Medicine Physician
  • Providence, RI
  • NPI 1649009507
  Medicare reassignment NPD
• Day Kimball Healthcare, Inc.

  • General Acute Care Hospital
  • Putnam, CT
  • NPI 1649243478
  Medicare reassignment NPD
• David Carpentier, MD Family Healthcare LTD

  • Emergency Medicine Physician
  • Cranston, RI
  • NPI 1144296054
  NPD
• Prospect Chartercare RWMC, LLC

  • Cardiovascular Disease Physician
  • Providence, RI
  • NPI 1326463548
  NPD
• Day Kimball Healthcare, Inc.

  • Community/Behavioral Health Agency
  • Putnam, CT
  • NPI 1104680966
  NPD
• Day Kimball Healthcare, Inc.

  • General Acute Care Hospital
  • Putnam, CT
  • NPI 1205056371
  NPD
• Landmark Medical Center

  • Internal Medicine Physician
  • Woonsocket, RI
  • NPI 1942412002

  Nurse Practitioner

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prospect Chartercare RWMC, LLC

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1013332014
  Care Compare affiliation

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

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1598101925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084735",
            "telephone_number": "401-456-2000",
            "fax_number": "401-434-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084735",
            "telephone_number": "401-474-4288",
            "fax_number": "401-434-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLIHER",
        "first_name": "PHYLLIS",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-13",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN00058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Kelley, MS, CGC
• Hayleigh Kelley
• Kaitlin Kelley, PMHNP
• Kerri Kelley, LICSW
• Edward Francis Kelliher, CRTT
• Christine M Kellogg, PTA
• Sarah A Kelly-Palmer, LICSW
• Allana W Kelly, OTR
• Bridget T Kelly, PSY.D
• Caitlin Kelly

• Family Nurse Practitioner in Providence, RI
• Providers in Providence, RI by specialty
• Family Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.