Terry A Kelley, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F303714-1 Issued in NY

Practice address

5415 W Genesee St Ste 301
Camillus, NY 13031-2162

Phone

(315) 487-8109

Fax

(315) 487-5680

NPI assigned

Jun 6, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

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.

• Preventive Medicine Associates LLC

  • Internal Medicine Physician
  • Camillus, NY
  • NPI 1710099304
  NPD

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1730618588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 W GENESEE ST STE 301",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130312162",
            "telephone_number": "315-487-8109",
            "fax_number": "315-487-5680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 W GENESEE ST STE 301",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130312162",
            "telephone_number": "315-487-8109",
            "fax_number": "315-487-5680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "TERRY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F303714-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• K Johnson MD
• Michael Paul Kaczor I, DDS
• Kathy Penner, LCSW, PLLC
• Suzanne Katko, AUD, CCC-A
• Heather Kehoe
• Lori Kelly, NP
• Patricia Ann Kelly, LPN
• Donna L Kenny, LPN
• Stacy D Keppler, PHARM D
• Jaclyn Marie Kerling, NP

• Adult Health Nurse Practitioner in Camillus, NY
• Providers in Camillus, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.