Kelley M. Anderson, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0024165264 Issued in VA

Practice address

130 Park St SE
#100
Vienna, VA 22180-4609

Phone

(703) 591-1280

Fax

(703) 591-1445

NPI assigned

May 12, 2006

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 DC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Blue Ridge Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Amherst, VA
  • NPI 1326566993

  Corporate Director

  CMS ownership

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.

• Washington Hospital Center Corp

  • Neurological Surgery Physician
  • Washington, DC
  • NPI 1407870124
  Medicare reassignment NPD
• Washington Hospital Center Corp

  • General Practice Physician
  • Washington, DC
  • NPI 1629394424
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1790735272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 PARK ST SE",
            "address_2": "#100",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804609",
            "telephone_number": "703-591-1280",
            "fax_number": "703-591-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 PARK ST SE",
            "address_2": "#100",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221804609",
            "telephone_number": "703-591-1280",
            "fax_number": "703-591-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KELLEY",
        "middle_name": "M.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024165264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Amponsah
• Vincent J Amuso Jr., DPT
• Jung Woo An
• Ayana Anderson
• Jaci Anderson
• Humberto Marcelo Andreoli, M.D.
• Hannah Andrews
• Barbara B Andrino, M.D.
• Bianca Molinari Anez, LPC
• Myra Harrill Angel, PH.D.

• Nurse Practitioner in Vienna, VA
• Providers in Vienna, VA by specialty
• Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.