Individual provider Active NPI

Patricia Kelly, C.N.P.

  • Family Nurse Practitioner
  • Painesville, OH
National Provider Identifier
1639362916
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
144814 Issued in OH
Practice address
7580 Auburn Rd
Suite 202
Painesville, OH 44077-9615
Phone
(440) 352-0400
Fax
(440) 352-4535
NPI assigned
Aug 21, 2007
Last updated
Mar 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 144814 OH Primary

Addresses

Primary practice location

7580 Auburn Rd
Suite 202
Painesville, OH 44077-9615

Mailing address

7580 Auburn Rd
Suite 202
Painesville, OH 44077-9615
Phone (440) 352-0400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address patricia.kelly@lhpg.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20071010000010 OH Practitioner - Nurse Practitioner 7113013947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Pacific University - College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Hospital System, Inc.Group PAC ID 6002713922, 92 clinicians

Practice addresses (Care Compare)

36500 Euclid Ave
Willoughby, OH 44094-4455
Phone (440) 516-0530

7580 Auburn Rd
Concord Township, OH 44077-9617

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
144814OHMDFamily Nurse Practitioner
APRN.CNP.04543OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Hospital System, Inc. CurrentSince Oct 1, 2010 Accepting new patients
Lake Hospital System, Inc CurrentSince Oct 1, 2010 Accepting new patients
Lake Hospital System Inc Current Accepting new patients
Lake Hospital System, Inc Past Accepting new patients

Locations

7515 Fredle Dr
Concord Township, OH 44077
Phone (440) 352-0400

7580 Auburn Rd
Ste 202
Concord Township, OH 44077
Phone (440) 352-0400

8300 Tyler Blvd
Ste 300
Mentor, OH 44060
Phone (440) 205-1529

10780 Kinsman Rd
Newbury, OH 44065
Phone (440) 564-5656

Interoperability endpoints

  • Direct secure messaging: pkelly28105@ehrdirect.uhhospitals.org

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1639362916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7580 AUBURN RD",
            "address_2": "SUITE 202",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440779615",
            "telephone_number": "440-352-0400",
            "fax_number": "440-352-4535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7580 AUBURN RD",
            "address_2": "SUITE 202",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440779615",
            "telephone_number": "440-352-0400",
            "fax_number": "440-352-4535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "PATRICIA",
        "credential": "C.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-21",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "144814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "patricia.kelly@lhpg.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Baseline West Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "7580 Auburn Rd",
            "address_2": "Suite 202",
            "city": "Painesville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440779615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Painesville, OH

Sources for this page

Verify at the official NPI Registry.