Individual provider Active NPI

Kathleen Mary Kelly Brown, NP

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1679636286
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
252702 Issued in MA
Practice address
100 Cambridge St FL 14
Boston, MA 02114-2509
Phone
(888) 731-8994
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 252702 MA Primary

Addresses

Primary practice location

100 Cambridge St FL 14
Boston, MA 02114-2509

Mailing address

100 Cambridge St FL 14
Boston, MA 02114-2509
Phone (888) 731-8994

Other practice location 1

139 Centre St Ph 120
New York, NY 10013-4559
Phone (888) 731-8994

Other names 1

  • Ms. Kathleen Mary Kelly Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20070425000488 MA Practitioner - Nurse Practitioner 3779688460 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Milford Regional Physician Group, Inc. CurrentSince Sep 23, 2019 Accepting new patients
Integrative Womens Care PC Past Accepting new patients

Locations

1280 W Central St
Ste 302
Franklin, MA 02038
Phone (508) 462-3910

68A Main St
Ste 101
Medway, MA 02053
Phone (508) 533-6020

115 Water St
Ste 105
Milford, MA 01757
Phone (508) 478-6880

9 Industrial Rd
Ste 5
Milford, MA 01757
Phone (508) 473-1480

308 Main St
Milford, MA 01757
Phone (508) 478-0555

100 Medway Rd
Ste 401
Milford, MA 01757
Phone (508) 634-7338

Interoperability endpoints

  • Direct secure messaging: kathleen.brown.1@27069.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1679636286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CAMBRIDGE ST FL 14",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142509",
            "telephone_number": "888-731-8994",
            "fax_number": "508-473-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CAMBRIDGE ST FL 14",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142509",
            "telephone_number": "888-731-8994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "139 Centre St Ph 120",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100134559",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KATHLEEN",
        "middle_name": "MARY KELLY",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "252702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "KELLY",
            "middle_name": "MARY",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.