Mandy A Kelly, MSED

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

300 Garden City Plaza
Suite 350
Garden City, NY 11530

Phone

(516) 747-9030

NPI assigned

Oct 30, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519948800000",
    "number": "1811241862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 QUINTIN COURT",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "11777",
            "telephone_number": "631-275-7059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GARDEN CITY PLAZA",
            "address_2": "SUITE 350",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "11530",
            "telephone_number": "516-747-9030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MANDY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MSED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-30",
        "last_updated": "2018-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NY",
            "license": "893451",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Marie Kelian, D.C.
• Venkata Krishnam Naidu Kella, M.D
• Adrienne Kelly
• Betty Ann Kelly, M.D.
• Kaitlyn Eileen Kelly
• Patricia Kelly, LPN
• Tara Kelly
• Theresa Kelly, PT, DPT, MS ED
• Matthew Kelpaire, PT,DPT
• Beth Ann Kendrick, CCC-SLP

• Specialist in Garden City, NY
• Providers in Garden City, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.