Active NPI
Kimberly A Kelly, CRNP
- Adult Health Nurse Practitioner
- Doylestown, PA
National Provider Identifier
1962458653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- TP006953C
- Practice address
- 310 Farm LN
Doylestown, PA 18901-4732 - Phone
- (215) 348-3990
- Fax
- (215) 348-7705
- NPI assigned
- May 25, 2006
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | TP006953C | PA | Primary |
| Adult Health Nurse Practitioner | 363LA2200X | RN332145L | PA |
Addresses
Primary practice location
310 Farm LN
Doylestown, PA 18901-4732
Mailing address
310 Farm LN
Doylestown, PA 18901-4732
Phone (215) 348-3990
Other identifiers 18
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0001435061 | Other | PERSONAL CHOICE 65 | |
| 2119896001 | Other | AMERIHEALTH HMO | |
| 598899143 | Other | MULTI PLAN | |
| 007302 | Other | AETNA PPO MANAGED CARE | |
| 4708888939 | Other | DEVON | |
| 4708888939 | Other | FIRST HEALTH CCN | |
| 0001435061 | Other | PENNSYLVANIA BLUE SHIELD | |
| 1058232 | Other | KEYSTONE MERCY HEALTH PLA | |
| 278862 | Other | MAMSI | |
| 470888939 | Other | PHCS | |
| CK4397 | Other | MEDICARE RAILROAD | |
| 2119896001 | Other | AMERIHEALTH ADMINISTRATOR | |
| 470888939 | Other | INTERCOUNTY | |
| P543147 | Other | OXFORD | |
| PC0140 | Other | HEALTH NET | |
| 007302 | Other | AETNA HMO | |
| 21198960001 | Other | KEYSTONE HEALTH PLAN EAST | |
| 21198960001 | Other | KEYSTONE HLTHPLAN EAST 65 |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN332145L | PA | MD | Adult Health Nurse Practitioner |
| TP006953C | PA | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266969600000",
"number": "1962458653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 FARM LN",
"city": "DOYLESTOWN",
"state": "PA",
"postal_code": "189014732",
"telephone_number": "215-348-3990",
"fax_number": "215-348-7705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 FARM LN",
"city": "DOYLESTOWN",
"state": "PA",
"postal_code": "189014732",
"telephone_number": "215-348-3990",
"fax_number": "215-348-7705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "KIMBERLY",
"middle_name": "A",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-25",
"last_updated": "2010-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "PA",
"license": "TP006953C",
"primary": true
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "PA",
"license": "RN332145L",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PERSONAL CHOICE 65",
"identifier": "0001435061",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH HMO",
"identifier": "2119896001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTI PLAN",
"identifier": "598899143",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO MANAGED CARE",
"identifier": "007302",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEVON",
"identifier": "4708888939",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH CCN",
"identifier": "4708888939",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PENNSYLVANIA BLUE SHIELD",
"identifier": "0001435061",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE MERCY HEALTH PLA",
"identifier": "1058232",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "278862",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS",
"identifier": "470888939",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "CK4397",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH ADMINISTRATOR",
"identifier": "2119896001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERCOUNTY",
"identifier": "470888939",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P543147",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "PC0140",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "007302",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE HEALTH PLAN EAST",
"identifier": "21198960001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE HLTHPLAN EAST 65",
"identifier": "21198960001",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Doylestown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.