Jeannine Mary Kelly, C.R.N.A.

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

332116L Issued in PA

Practice address

111 S 11TH St # 8490
Philadelphia, PA 19107-4824

Phone

(215) 955-6161

Fax

(215) 923-5507

NPI assigned

Jun 2, 2006

Last updated

Jun 30, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ambulatory Anesthesia Specialists, P.C.Group PAC ID 6608854435, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Ambulatory Anesthesia Specialists, P.C.

  • Anesthesiology Physician
  • Paoli, PA
  • NPI 1649227372
  Medicare reassignment Care Compare group NPD
• Society Hill Anesthesia Consultants of New Jersey, PC

  • Anesthesiology Physician
  • Cherry Hill, NJ
  • NPI 1396797445
  NPD (past)

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1710925821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SCOTT NIXON MEMORIAL DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 11TH ST # 8490",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074824",
            "telephone_number": "215-955-6161",
            "fax_number": "215-923-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JEANNINE",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "332116L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Marie Kelly, DO
• Jake L Kelly
• James Kelly, PA-C
• Janice A Kelly, M.D.
• Jashawn Kelly
• Jennifer Kelly, RPH
• Jennifer L Kelly, MSPT
• Jessica Kelly, MD
• Jillian Alexandria Kelly, CRNP
• Joanne Kelly

• Certified Registered Nurse Anesthetist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Certified Registered Nurse Anesthetist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.