Active NPI
Kelly M Stanley, MD
- Pediatrics Physician
- Orange, CA
National Provider Identifier
1922561109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0101274940
- Practice address
- 1201 W la Veta Ave
Orange, CA 92868-4203 - Phone
- (714) 509-4373
- NPI assigned
- Apr 13, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 200829 | CA | |
| Pediatrics Physician | 208000000X | 0101274940 | VA | Primary |
Addresses
Primary practice location
1201 W la Veta Ave
Orange, CA 92868-4203
Mailing address
1201 W la Veta Ave
Orange, CA 92868-4203
Phone (714) 509-4373
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190708002303 | AZ | Order and Referring Only - Pediatric Medicine | 1355676784 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200829 | CA | MD | Neonatal-Perinatal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750118400000",
"number": "1922561109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 W LA VETA AVE",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684203",
"telephone_number": "714-509-4373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 W LA VETA AVE",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684203",
"telephone_number": "714-509-4373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANLEY",
"first_name": "KELLY",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-13",
"last_updated": "2025-06-17",
"certification_date": "2025-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "CA",
"license": "200829",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0101274940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.