Individual provider Active NPI

Kelly Obrien, ACNP

  • Acute Care Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1629701776
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
68843 Issued in NM
Practice address
2129 Osuna Rd NE
Albuquerque, NM 87113-1002
Phone
(505) 898-2468
NPI assigned
Jul 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 68843 NM Primary

Addresses

Primary practice location

2129 Osuna Rd NE
Albuquerque, NM 87113-1002

Mailing address

6329 Loftus Ave NE
Albuquerque, NM 87109-2717
Phone (505) 720-9564

Other practice location 1

700 High St NE
Albuquerque, NM 87102-2565
Phone (505) 242-4444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20221101002435 NM Practitioner - Nurse Practitioner 8527435767 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Medical LLCGroup PAC ID 6103071428, 2 clinicians
House Calls of New Mexico LLCGroup PAC ID 0345291191, 9 clinicians

Practice addresses (Care Compare)

1525 N Renaissance Blvd NE
Albuquerque, NM 87107-6827
Phone (575) 623-1303

2129 Osuna Rd NE
Suite C
Albuquerque, NM 87113-1002
Phone (505) 554-4080

Hospital & facility affiliations

  • Ambercare Home Health Home health agency, Belen, NM, CCN 327123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
68843NMMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
House Calls of New Mexico LLC CurrentSince Sep 1, 2022 Accepting new patients
Elite Medical LLC CurrentSince Dec 1, 2022 Accepting new patients

Locations

801 Warrenville Rd
Ste 800
Lisle, IL 60532

2129 Osuna Rd NE
Ste C
Albuquerque, NM 87113
Phone (505) 554-4080

1525 N Renaissance Blvd NE
Albuquerque, NM 87107
Phone (505) 243-3387

2129 Osuna Rd NE
Albuquerque, NM 87113
Phone (505) 244-0046

100 N Pennsylvania Ave
Roswell, NM 88203
Phone (575) 623-1303

6303 Cowboys Way
Ste 600
Frisco, TX 75034

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1629701776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6329 LOFTUS AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092717",
            "telephone_number": "505-720-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2129 OSUNA RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131002",
            "telephone_number": "505-898-2468"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 High St NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871022565",
            "country_code": "US",
            "telephone_number": "505-242-4444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBRIEN",
        "first_name": "KELLY",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-06",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NM",
            "license": "68843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.