Jane Kelly, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

51782 Issued in TN

Practice address

2035 Saint John Ave
Dyersburg, TN 38024-2209

Phone

(731) 285-1393

Fax

(731) 660-8739

NPI assigned

Jan 10, 2014

Last updated

Jan 10, 2014By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Pathways of Tennessee, Inc.

  • Clinic/Center
  • Jackson, TN
  • NPI 1497721609
  NPD (past)

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

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389312000000",
    "number": "1659793685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 HIGHWAY 45 BYP",
            "address_2": "STE 604",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383054436",
            "telephone_number": "731-512-1273",
            "fax_number": "731-660-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 SAINT JOHN AVE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242209",
            "telephone_number": "731-285-1393",
            "fax_number": "731-660-8739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JANE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-10",
        "last_updated": "2014-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "51782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johnny Barry Joyner, MD
• Maryann Elizabeth Joyner
• Jonathan Bruce Junkin, DDS
• Pamela Kelley, MSW, COUNSELOR
• Kelly M. Walker DPM,PLLC (Walker Foot and Ankle)
• Kenneth L. Brunson, DDS, Ms, PC
• Troy A Kerber, DMD
• Keystone Memphis LLC (McDowell Center for Children)
• Keystone Memphis, LLC
• Kidney Experts PLLC (The Kidney Experts)

• Licensed Practical Nurse in Dyersburg, TN
• Providers in Dyersburg, TN by specialty
• Licensed Practical Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.