MRS. COLLEEN DENISE KELLEY PA-C
NPI 1861433088
Physician Assistant - Medical in Reston, VA

Q: What is Colleen Kelley's NPI number?

The NPI number for Colleen Kelley is 1861433088. It was assigned to this individual provider in the NPPES registry on June 9, 2006.

Q: What is Colleen Kelley's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Colleen Kelley was last updated on November 23, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 09, 2006PECOS Enrolled

11234 LEATHERWOOD DR, RESTON, VA 20191(703) 391-0758(703) 391-0758 Get Directions Write a Review

NPPES record last updated: November 23, 2010. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mrs. Colleen Denise Kelley Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. COLLEEN DENISE KELLEY PA-C (NPI 1861433088) is an individual medical provider in Reston, Virginia, licensed in Virginia (0110840732) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1861433088

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameMRS. COLLEEN DENISE KELLEYCredential: PA-C

Location Address11234 LEATHERWOOD DRReston, VA 20191-4607

Mailing Address12255 Fair Lakes PkwyFairfax, VA 22033-3952 · (703) 934-5700

Phone(703) 391-0758

Fax(703) 391-0758

Sole ProprietorNo

Enumeration DateJune 9, 2006

Last NPPES UpdateNovember 23, 2010

✔ NPI 1861433088 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in VA · 0110840732

11234 LEATHERWOOD DR, Reston, VA 20191

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Other Identifiers 1

Medicare ID-Type Unspecified006968M92VA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Colleen Denise Kelley Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Colleen Kelley's NPI number?

The NPI number for Colleen Kelley is 1861433088. It was assigned to this individual provider in the NPPES registry on June 9, 2006.

Where is Colleen Kelley located?

Colleen Kelley practices at 11234 Leatherwood Dr, Reston, VA 20191. The listed phone number is (703) 391-0758.

What is Colleen Kelley's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Colleen Kelley enrolled in Medicare?

Yes. Colleen Kelley is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Colleen Kelley was last updated on November 23, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.