Lisa M Kelley, N.P.

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

0050-03621 Issued in NC

Practice address

2711 Randolph Rd
Suite 100
Charlotte, NC 28207-2034

Phone

(704) 342-9550

Fax

(704) 377-0353

NPI assigned

Dec 14, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299024000000",
    "number": "1669457420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 RANDOLPH RD",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072034",
            "telephone_number": "704-342-9550",
            "fax_number": "704-377-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 RANDOLPH RD",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072034",
            "telephone_number": "704-342-9550",
            "fax_number": "704-377-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2011-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "VA",
            "license": "0024165508",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NC",
            "license": "0050-03621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chandra Kelley, M.S., CF-SLP
• Chelita Kaye Kelley, D.D.S.
• Emma Kelley
• Kailey Kelley, LCSW
• Kelsey Jean Kelley, OTR/L
• Mya H Kelley, M.A., CCC-SLP
• Robert Griffin Kelley Jr., MD
• Simone D Kelley
• Andrea Kellner, COTA/L
• Kellogg Medical PLLC

• Women's Health Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Women's Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; 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.