Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1245769074 Individual Practitioner Female Practitioner

Noelle Catherine Kellicker , CNP

Nurse Practitioner - Pediatrics • Worcester, MA

Professional Overview & Biography Verified Profile Summary

Noelle Kellicker, CNP is a registered healthcare professional specializing in Nurse Practitioner - Pediatrics in Worcester, MA. Practice services are available at 55 LAKE AVE N under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

55 Lake Ave N

Worcester, MA 016550002

Telephone 7744422853
Fax 7744437268
Associated Practice Facility / Clinic
🏢 Umass Memorial Medical Center Facility NPI 1679574933

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Pediatrics in Worcester, MA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 5.0 Yrs
State Avg: 17.3 Yrs
Regional Practice Density
21 Specialists

Practicing in Worcester, MA (1318 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-03-29
Nurse Practitioner - Pediatrics Primary Specialty

NUCC Taxonomy Code: 363LP0200X

State License MA RN2315082

Definition to come...

Registered Nurse - Pediatrics

NUCC Taxonomy Code: 163WP0200X

State License MA RN2315082

Definition to come...

Nurse Practitioner

NUCC Taxonomy Code: 363L00000X

State License MA RN2315082

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Secondary Practice Locations

26 Queen Street, Credentialing Dept./medical Services

Worcester, MA 016102473

Phone: 5088607800

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

19 Associated Practitioners
Suzanne Jacobs , LICSW

Social Worker - Clinical

NPI 1043271513

Licensed Independent Clinical Social Worker

NPI 1083760623

Doctor of Medicine (M.D.), Master of Public Health

NPI 1124380563

Doctor of Medicine (M.D.)

NPI 1164093662

Doctor of Medicine (M.D.)

NPI 1255074126

Doctor of Medicine (M.D.)

NPI 1346602364

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events
📍
Updated Practice Location January 09, 2021

Registered at 55 LAKE AVE N, WORCESTER, MA 016550002 (Tel: 7744422853)

📍
Updated Business Mailing Address January 09, 2021

Registered at PO BOX 415348, BOSTON, MA 022415348 (Tel: 8002258885)

👤
Provider Name / Credentials Updated January 09, 2021

Recorded as NOELLE KELLICKER, CNP

NPI Profile Active August 05, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location August 05, 2017

Registered at 26 QUEEN STREET, CREDENTIALING DEPT./MEDICAL SERVICES, WORCESTER, MA 016102473 (Tel: (508) 860-7800)

📍
Updated Business Mailing Address August 05, 2017

Registered at 26 QUEEN STREET, CREDENTIALING DEPT./MEDICAL SERVICES, WORCESTER, MA 016102473 (Tel: 5088607800)

👤
Provider Name / Credentials Updated August 05, 2017

Recorded as NOELLE KELLICKER, NP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 05, 2017

Registered Nurse (License #RN2315082 in MA)

NPI Profile Active June 06, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location June 06, 2017

Registered at 26 QUEEN STREET, CREDENTIALING DEPT./MEDICAL SERVICES, WORCESTER, MA 016102473 (Tel: (508) 860-7800)

📍
Updated Business Mailing Address June 06, 2017

Registered at 26 QUEEN STREET, CREDENTIALING DEPT./MEDICAL SERVICES, WORCESTER, MA 016102473 (Tel: 5088607800)

👤
Provider Name / Credentials Updated June 06, 2017

Recorded as NOELLE KELLICKER, NP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 06, 2017

Registered Nurse (License #RN2315082 in MA)

🟢
Initial NPI Registration & Enumeration June 06, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1245769074
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 06, 2017
Last Update: July 21, 2022
Sole Proprietor: No

Mailing Address

Po Box 415348

Boston, MA 022415348

Phone: 8002258885

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.