Kelly Anne O'Connell, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP019217 Issued in PA

Practice address

10 Shurs LN Ste 203
Philadelphia, PA 19127-2123

Phone

(215) 482-1234

NPI assigned

Mar 4, 2015

Sex

Female

Sole proprietor

Yes

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

Enrolled in PA

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Temple Faculty Practice Plan Inc

  • Anesthesiology Physician
  • Philadelphia, PA
  • NPI 1881176949
  Medicare reassignment Care Compare group NPD
• Chestnut Hill Clinic Company, LLC

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1508936071
  Medicare reassignment NPD
• Drexel University

  • Psychologist
  • Philadelphia, PA
  • NPI 1902900095
  Medicare reassignment NPD
• Tower Drexel Academic Medical Group LLC

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1780227488
  Medicare reassignment NPD
• Chestnut Hill Clinic Company, LLC

  • Sports Medicine (Family Medicine) Physician
  • Philadelphia, PA
  • NPI 1811611692
  NPD
• Drexel University

  • Audiologist
  • Elkins Park, PA
  • NPI 1104822253
  NPD
• Drexel University

  • Radiation Oncology Physician
  • Philadelphia, PA
  • NPI 1134224504
  NPD
• Temple Faculty Practice Plan Inc

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1073095915
  NPD
• Tower Drexel Academic Medical Group LLC

  • Sports Medicine (Family Medicine) Physician
  • Philadelphia, PA
  • NPI 1225660095
  NPD
• Tower Drexel Academic Medical Group LLC

  • Sports Medicine (Family Medicine) Physician
  • Philadelphia, PA
  • NPI 1346872116
  NPD
• Temple Faculty Practice Plan Inc

  • Urology Physician
  • Voorhees, NJ
  • NPI 1407638794
  NPD
• Temple Faculty Practice Plan Inc

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1285116228
  NPD (past)

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

{
    "created_epoch": "1425427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1861884546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SHURS LN STE 203",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191272123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 SHURS LN STE 203",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191272123",
            "telephone_number": "215-482-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "219 N Broad St Fl 1",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191071519",
            "country_code": "US",
            "telephone_number": "215-762-5145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Franklin Town Blvd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191031238",
            "country_code": "US",
            "telephone_number": "215-240-8915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "KELLY",
        "middle_name": "ANNE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-04",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN628832",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP019217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail M O'Connell
• Alanna O'Connell, D.O.
• Daniel Michael O'Connell, M.D.
• James R O'Connell, MD
• Katherine O'Connell, CRNP
• Megan O'Connell, CRNP
• Susan Brooke O'Connell, CPNP
• William Francis O'Connell, M.D.
• Debra F. O'Connor, CRNA
• Ellen M. O'Connor, MD

• Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; 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.