Susan R Kelly, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN048042-23 Issued in NH

Practice address

280 Pleasant St
Ste 1
Concord, NH 03301

Phone

(603) 622-8665

Fax

(833) 413-4978

NPI assigned

Oct 5, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Susan R. Carnegie Former name

Medicare fee-for-service enrollment

Enrolled in NH, VT2 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

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.

• Fusion Behavioral Care, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Concord, NH
  • NPI 1497512198
  Medicare reassignment NPD
• Matrix Health Systems P.C.

  • Clinical Psychologist
  • Burlington, VT
  • NPI 1104872712
  Medicare reassignment NPD
• Mindcare Solutions PC

  • Psychiatry Physician
  • Roanoke, VA
  • NPI 1992503544
  NPD
• Jwalant Vadalia MD PC

  • Psychiatry Physician
  • Manchester, NH
  • NPI 1346329133
  NPD (past)

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1659368595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 PLEASANT ST",
            "address_2": "STE 1",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "03301",
            "telephone_number": "603-622-8665",
            "fax_number": "833-413-4978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 PLEASANT ST",
            "address_2": "STE 1",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "03301",
            "telephone_number": "603-622-8665",
            "fax_number": "833-413-4978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Canton St.",
            "address_2": "Suite 13",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "03103",
            "country_code": "US",
            "telephone_number": "603-625-1670",
            "fax_number": "603-625-0335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SUSAN",
        "middle_name": "R",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "RN048-042-21",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "NH",
            "license": "048042-23",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "APRN048042-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "40V001351NH01",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "CARNEGIE",
            "middle_name": "R.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jill Michlovitz Keller, PT
• Tori Kelley, BA
• Carl Thomas Kelly, R.PH.
• Janet Kelly
• Ryan Kelly, DPT
• Steven Kelm, CRNA
• Kemet Health One LLC
• Doris T Kendall, LCMHC
• Kristen Kenison
• Amy Lynne Kennedy, APRN

• Psychiatric/Mental Health Nurse Practitioner in Concord, NH
• Providers in Concord, NH by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.