Individual provider Active NPI

Kellie Novakovich, RN

  • Certified Registered Nurse Anesthetist
  • Pittsburgh, PA
National Provider Identifier
1902107980
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN586948 Issued in PA
Practice address
4800 Friendship Ave
Pittsburgh, PA 15224-1722
Phone
(412) 578-5323
Fax
(412) 605-6425
NPI assigned
Nov 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN586948 PA Primary

Addresses

Primary practice location

4800 Friendship Ave
Pittsburgh, PA 15224-1722

Mailing address

4800 Friendship Ave
Pittsburgh, PA 15224-1722
Phone (412) 578-5323

Other practice location 1

720 Blackburn Rd
Sewickley, PA 15143-1459
Phone (412) 749-7310

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address knovakovich11226@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN586948PAMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1902107980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 FRIENDSHIP AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152241722",
            "telephone_number": "412-578-5323",
            "fax_number": "412-605-6425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 FRIENDSHIP AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152241722",
            "telephone_number": "412-578-5323",
            "fax_number": "412-605-6425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Blackburn Rd",
            "address_purpose": "LOCATION",
            "city": "Sewickley",
            "state": "PA",
            "postal_code": "151431459",
            "country_code": "US",
            "telephone_number": "412-749-7310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOVAKOVICH",
        "first_name": "KELLIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-08",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN586948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knovakovich11226@direct.ahn.org",
            "affiliation": "N",
            "address_1": "4800 Friendship Ave",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152241722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.