Individual provider Active NPI

Kathleen E Kelly, RN

  • Maternal Newborn Registered Nurse
  • Stroudsburg, PA
National Provider Identifier
1700937877
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal Newborn Registered NurseTaxonomy code 163WM0102X
License
RN349793L Issued in PA
Practice address
2 Veterans PL
PMC Learning Institute
Stroudsburg, PA 18360-2494
Phone
(570) 426-1688
Fax
(570) 426-1832
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal Newborn Registered Nurse 163WM0102X RN349793L PA Primary

Addresses

Primary practice location

2 Veterans PL
PMC Learning Institute
Stroudsburg, PA 18360-2494

Mailing address

206 E Brown St
Pocono Healthcare MGMT - Professional BLDG
E Stroudsburg, PA 18301-3006
Phone (570) 420-4969

Other identifiers 1

IdentifierTypeStateIssuer
1016058300001MedicaidPA

Other names 1

  • Kathleen Picerno Former name

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

LicenseStateTypeSpecialty
RN349793LPAMDMaternal Newborn Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pocono Medical Center 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1700937877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 E BROWN ST",
            "address_2": "POCONO HEALTHCARE MGMT - PROFESSIONAL BLDG",
            "city": "E STROUDSBURG",
            "state": "PA",
            "postal_code": "183013006",
            "telephone_number": "570-420-4969",
            "fax_number": "570-476-3754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 VETERANS PL",
            "address_2": "PMC LEARNING INSTITUTE",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183602494",
            "telephone_number": "570-426-1688",
            "fax_number": "570-426-1832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KATHLEEN",
        "middle_name": "E",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0102X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "PA",
            "license": "RN349793L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016058300001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "PICERNO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; 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.