Active NPI
Kelly Ann O'Leary, RN
- Registered Nurse
- Bronx, NY
National Provider Identifier
1689954570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 647303-1
- Practice address
- 4377 Bronx Blvd
Suite 202
Bronx, NY 10466-1397 - Phone
- (914) 844-7454
- NPI assigned
- Aug 23, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 647303-1 | NY | Primary |
Addresses
Primary practice location
4377 Bronx Blvd
Suite 202
Bronx, NY 10466-1397
Mailing address
PO Box 393
Shenorock, NY 10587-0393
Phone (914) 844-7454
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 647303-1 | NY | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Fleurantin Corp | Past | Accepting new patients |
Organizations & group practices 1
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": "1314057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314057600000",
"number": "1689954570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 393",
"city": "SHENOROCK",
"state": "NY",
"postal_code": "105870393",
"telephone_number": "914-844-7454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4377 BRONX BLVD",
"address_2": "SUITE 202",
"city": "BRONX",
"state": "NY",
"postal_code": "104661397",
"telephone_number": "914-844-7454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'LEARY",
"first_name": "KELLY",
"middle_name": "ANN",
"name_prefix": "Miss",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-23",
"last_updated": "2011-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "647303-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.