Connie Diane Kelly, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F332008-1 Issued in NY

Practice address

39 Pearl St W
Sidney, NY 13838-1330

Phone

(252) 354-7622

NPI assigned

Apr 18, 2007

Last updated

Oct 23, 2008By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Chenango Memorial Hospital, Inc.

  • Family Medicine Physician
  • Norwich, NY
  • NPI 1467526889

  Nurse Practitioner

  NPD (past)
• Delaware Valley Hospital, Inc

  • Critical Access Hospital Clinic/Center
  • Walton, NY
  • NPI 1144312646
  NPD (past)
• Delaware Valley Hospital, Inc

  • Critical Access Hospital Clinic/Center
  • Walton, NY
  • NPI 1801132923
  NPD (past)
• Mary Imogene Bassett Hospital

  dba FoxCare Pharmacy

  • Specialty Pharmacy
  • Oneonta, NY
  • NPI 1174419196
  NPD (past)

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224720000000",
    "number": "1760609382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1937 GIBSON HILL RD",
            "city": "FRANKLIN",
            "state": "NY",
            "postal_code": "137754425",
            "telephone_number": "607-287-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 PEARL ST W",
            "city": "SIDNEY",
            "state": "NY",
            "postal_code": "138381330",
            "telephone_number": "252-354-7622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CONNIE",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2008-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F332008-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua House Inc
• Joshua House Inc.
• Joshua House Inc.
• Kimberly Ann Kappauf, MA CCC-SLP
• Rani Kapur-Pado, D.O.
• Kmart Pharmacy Corporation LLC
• Jennifer M Lavare, NP
• Darcee Lyn Lewis, LPN
• David William Lewis, RPH
• Lifemotion Works LLC (LifeMotion PT)

• Nurse Practitioner in Sidney, NY
• Providers in Sidney, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; 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.