Deirdre Mary Kelley, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

F401683-1 Issued in NY

Practice address

1111 Elmwood Ave BLDG 16
Rochester, NY 14620-3005

Phone

(585) 241-1262

NPI assigned

Sep 18, 2014

Last updated

Sep 18, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1942602198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 ELMWOOD AVE BLDG 16",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146203005",
            "telephone_number": "585-241-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 ELMWOOD AVE BLDG 16",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146203005",
            "telephone_number": "585-241-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "DEIRDRE",
        "middle_name": "MARY",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-18",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F401683-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rita Conti Keller, RPH
• Sara Lynne Keller, PA
• Amanda Kelley, MS, RN, AGCNS-BC
• Cheryl A. Kelley, D.M.D.
• Christen Noel Kelley, MHC
• John Kelley, PT, DPT
• Kristy Kelley, PSYD
• Sheila Phelps Kelley, M.D., PH.D.
• Laura J Kellogg
• Melissa Marie Kellogg, PMHNP

• Psychiatric/Mental Health Nurse Practitioner in Rochester, NY
• Providers in Rochester, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.

Verify at the official NPI Registry.