Mary Ann Kelly, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

003508 Issued in CT

Practice address

28 Crescent St
Middlesex Hospital 7TH FL
Middletown, CT 06457-3654

Phone

(860) 358-6760

Fax

(860) 358-4829

NPI assigned

May 5, 2008

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Clinical Nurse Specialist (CNS)

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paragon Behavioral Health, LLCGroup PAC ID 1850301508, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Paragon Behavioral Health, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Kensington, CT
  • NPI 1972620961
  Medicare reassignment Care Compare group NPD
• Middlesex Hospital

  • Psychiatry Physician
  • Middletown, CT
  • NPI 1760451041

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Middlesex Hospital

  • General Acute Care Hospital
  • Middletown, CT
  • NPI 1760454334
  Medicare reassignment NPD
• Connecticut Pathology Group PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Middletown, CT
  • NPI 1740219625
  NPD
• Middlesex Hospital

  • Community Based Hospice Care Agency
  • Middletown, CT
  • NPI 1003873233
  NPD
• Middlesex Hospital

  • Family Medicine Physician
  • Middletown, CT
  • NPI 1851350664
  NPD
• Paragon Behavioral Health, LLC

  • Psychiatry Physician
  • Kensington, CT
  • NPI 1184733107

  Psychiatric/Mental Health

  NPD
• Paragon Behavioral Health, LLC

  • Marriage & Family Therapist
  • Berlin, CT
  • NPI 1629890553
  NPD
• Middlesex Hospital

  • Family Nurse Practitioner
  • Middletown, CT
  • NPI 1972563138
  NPD (past)

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209945600000",
    "number": "1760658207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "address_2": "MIDDLESEX HOSPITAL 7TH FL",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-358-6760",
            "fax_number": "860-358-4829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "address_2": "MIDDLESEX HOSPITAL 7TH FL",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573654",
            "telephone_number": "860-358-6760",
            "fax_number": "860-358-4829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MARY ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-05",
        "last_updated": "2008-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "003508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT  APRN LICENSE",
            "identifier": "003508",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Clare Keast, RN CBS PMH-C
• Alexa Cathleen Keating, PT, DPT
• Patrick Thomas Kehl, MD
• Amanda Kathryn Kell
• Gillian R. Kelly, D.M.D.,M.S.D.
• Michael Kelly, DMD
• Kate Kennedy, LCSW
• Emmanuel Kenta-Bibi, MD
• Eucharia Mambo Kenta-Bibi, MD
• Karen Keramidas, RN

• Psychiatric/Mental Health Nurse Practitioner in Middletown, CT
• Providers in Middletown, CT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.