Individual provider Active NPI

Elizabeth R Kelly, APRN

  • Family Nurse Practitioner
  • Keene, NH
National Provider Identifier
1689000960
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
039898-23 Issued in NH
Practice address
229 Main St
Center for Health and Wellness (2802)
Keene, NH 03435-0001
Phone
(603) 358-2450
NPI assigned
Sep 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 039898-23 NH Primary

Addresses

Primary practice location

229 Main St
Center for Health and Wellness (2802)
Keene, NH 03435-0001

Mailing address

229 Main St
Center for Health and Wellness (2802)
Keene, NH 03435-0001
Phone (603) 358-2450

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address staff_mano@gohnh.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20150928002165 NH Practitioner - Nurse Practitioner 1850609645 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
039898-23NHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Medical Center CurrentSince Jan 1, 2019 Accepting new patients
Catholic Medical Center CurrentSince Jul 13, 2015 Accepting new patients
Catholic Medical Center CurrentSince Jul 13, 2015 Accepting new patients

Locations

100 McGregor St
Manchester, NH 03102
Phone (603) 663-6931

Organizations & group practices 3

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": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1689000960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 MAIN ST",
            "address_2": "CENTER FOR HEALTH AND WELLNESS (2802)",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034350001",
            "telephone_number": "603-358-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 MAIN ST",
            "address_2": "CENTER FOR HEALTH AND WELLNESS (2802)",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034350001",
            "telephone_number": "603-358-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ELIZABETH",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "039898-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "staff_mano@gohnh.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 McGregor St",
            "city": "Manchester",
            "state": "NH",
            "country_code": "US",
            "postal_code": "031023730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Keene, NH

Sources for this page

Verify at the official NPI Registry.