Individual provider Active NPI

Kevin Anthony Okelly, LICENSED PRACTICAL N

  • Licensed Practical Nurse
  • Brooklyn, NY
National Provider Identifier
1992022156
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
271275 Issued in NY
Practice address
2907 Fort Hamilton Pkwy
Unit 2
Brooklyn, NY 11218-1680
Phone
(347) 204-0609
NPI assigned
Apr 28, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 271275 NY Primary

Addresses

Primary practice location

2907 Fort Hamilton Pkwy
Unit 2
Brooklyn, NY 11218-1680

Mailing address

2907 Fort Hamilton Pkwy
Unit 2
Brooklyn, NY 11218-1680

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
271275NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386288000000",
    "number": "1992022156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2907 FORT HAMILTON PKWY",
            "address_2": "UNIT 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112181680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2907 FORT HAMILTON PKWY",
            "address_2": "UNIT 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112181680",
            "telephone_number": "347-204-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKELLY",
        "first_name": "KEVIN",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "LICENSED PRACTICAL N",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-28",
        "last_updated": "2013-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "271275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; 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.