Individual provider Active NPI

Lea Rene Kelly, NP-C

  • Nurse Practitioner
  • Providence, RI
National Provider Identifier
1790295285
Registry record updated Oct 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN01693 Issued in RI
Practice address
33 Staniford St
Providence, RI 02905-3105
Phone
(401) 421-8800
NPI assigned
Oct 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN01693 RI Primary

Addresses

Primary practice location

33 Staniford St
Providence, RI 02905-3105

Mailing address

33 Staniford St
Providence, RI 02905-3105
Phone (401) 421-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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

Enrollment IDStateProvider typePAC IDDetails
I20171214001522 RI Practitioner - Nurse Practitioner 1759649072 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Gastroenterology, LLCGroup PAC ID 3678762804, 99 clinicians

Practice addresses (Care Compare)

33 Staniford St
Providence, RI 02905-3105
Phone (401) 421-8800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Gastroenterology, LLC CurrentSince Oct 14, 2017 Accepting new patients
Gastroenterology Associates Inc CurrentSince Jan 17, 2025 Accepting new patients

Locations

33 Staniford St
Providence, RI 02905
Phone (401) 274-1810

44 W River St
Providence, RI 02904
Phone 4012744800201

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BBICBD

Organizations & group practices 2

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507593600000",
    "number": "1790295285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 STANIFORD ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053105",
            "telephone_number": "401-421-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 STANIFORD ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053105",
            "telephone_number": "401-421-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LEA",
        "middle_name": "RENE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-10",
        "last_updated": "2017-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN01693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.