Individual provider Active NPI

Kathy Rochelle O'Kelley, NP

  • Family Nurse Practitioner
  • Ladera Ranch, CA
National Provider Identifier
1801107313
Registry record updated Jan 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19801 Issued in CA
Practice address
27522 Antonio Pkwy Ste P3
Ladera Ranch, CA 92694-2166
Phone
(949) 813-3596
NPI assigned
Jun 30, 2010
Last updated
Jan 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 19801 CA Primary

Addresses

Primary practice location

27522 Antonio Pkwy Ste P3
Ladera Ranch, CA 92694-2166

Mailing address

27522 Antonio Pkwy Ste P3
Ladera Ranch, CA 92694-2166
Phone (949) 813-3596

Other identifiers 1

IdentifierTypeStateIssuer
2018079236OtherCAFNP BOARD CERTIFICATION

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190319002544 CA Practitioner - Nurse Practitioner 4284974734 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael Tehrani MD ApcGroup PAC ID 7810204575, 9 clinicians

Practice addresses (Care Compare)

1703 Termino Ave
Suite 108
Long Beach, CA 90804-2126
Phone (562) 498-2481

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19801CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Housecall Doctors Medical Group Inc CurrentSince Mar 4, 2019 Accepting new patients

Locations

3800 Kilroy Airport Way
Ste 270
Long Beach, CA 90806
Phone (949) 366-1053

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577836800000",
    "number": "1801107313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27522 ANTONIO PKWY STE P3",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926942166",
            "telephone_number": "949-813-3596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27522 ANTONIO PKWY STE P3",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926942166",
            "telephone_number": "949-813-3596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'KELLEY",
        "first_name": "KATHY",
        "middle_name": "ROCHELLE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2020-01-01",
        "certification_date": "2020-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "19801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FNP BOARD CERTIFICATION",
            "identifier": "2018079236",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ladera Ranch, CA

Sources for this page

Verify at the official NPI Registry.