Sharon Kay Kelly, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9993 Issued in CA

Practice address

3201 W 6TH St
Los Angeles, CA 90020-5001

Phone

(888) 227-3312

NPI assigned

Oct 19, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CA

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

Nurse Practitioner

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Facey Medical FoundationGroup PAC ID 3173436276, 324 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Providence Facey Medical Foundation

  dba Facey Medical Group

  • Internal Medicine Physician
  • Valencia, CA
  • NPI 1710031588
  Medicare reassignment Care Compare group
• Carbon Health Primary Care of California PC

  • Multi-Specialty Clinic/Center
  • Berkeley, CA
  • NPI 1972057990
  NPD (past)

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1790774057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 50670",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900740670",
            "telephone_number": "888-227-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 W 6TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900205001",
            "telephone_number": "888-227-3312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2825 Butler Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900643807",
            "country_code": "US",
            "telephone_number": "310-924-4789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6245 Busch Dr",
            "address_purpose": "LOCATION",
            "city": "Malibu",
            "state": "CA",
            "postal_code": "902653834",
            "country_code": "US",
            "telephone_number": "310-457-1495",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2010 Wilshire Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900573507",
            "country_code": "US",
            "telephone_number": "213-483-1800",
            "fax_number": "213-483-1494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SHARON",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-19",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NPF9993",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "9993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skelly1629881@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "3201 W 6th St",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900205001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skelly1629881@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "57 Prism",
            "city": "Irvine",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926183148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patrick Kevin Kelly
• Rachael Angeli Kelly
• Rita M Kelly
• Rose Victoria Kelly
• Sarah Kelly
• Shernedra Kelly
• Talia Sadell Kelly
• Tara Lee Kelly, PH.D.
• Zachary Kelly
• Alex Robert Kelman, PH.D.

• Family Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; 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.