Kellys Private Home Care

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

341974760503 Issued in NY

Legal business name

KELLYS PRIVATE HOME CARE

Practice address

93 Chapel Rd.
Hannibal, NY 13074

Phone

(315) 427-3753

NPI assigned

Jan 15, 2015

Last updated

Jan 15, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Kelly Greenleaf, CNA

Title

Cna/Owner

Phone

(315) 427-3753

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421280000000",
    "number": "1679962518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 CHAPEL RD.",
            "city": "HANNIBAL",
            "state": "NY",
            "postal_code": "13074",
            "telephone_number": "315-427-3753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 CHAPEL RD.",
            "city": "HANNIBAL",
            "state": "NY",
            "postal_code": "13074",
            "telephone_number": "315-427-3753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLYS PRIVATE HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-15",
        "last_updated": "2015-01-15",
        "status": "A",
        "authorized_official_last_name": "GREENLEAF",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CNA/OWNER",
        "authorized_official_telephone_number": "315-427-3753",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CNA"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "NY",
            "license": "341974760503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hess Healthcare, LLC (Hannibal Pharmacy)
• Erin E Hess, PHARMD
• Jonathan Allen Hess, R.PH.
• Jennifer Hawkins Licensed Mental Health Counseling PLLC (Inner Strength Counseling Services)
• Laurel Jicha, BSN
• Gage Michael Kennedy, LPN
• Tammy Lynne Kimpland, RN
• Tiffany L Labonoski I, LPN
• Wendie Grace Lambert
• Amy Laurion

• Nurse's Aide in Hannibal, NY
• Providers in Hannibal, NY by specialty
• Nurse's Aide in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; 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.