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Export Provider Record NPI 1114733417
Tenesha Shanta Kelly-RobertsFNP-C
Active
NPI Number1114733417
NPI TypeNPI-1 Individual
SpecialtyRegistered Nurse, General Practice
Provider Details
NPI1114733417
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2024-12-10
Last Updated2026-05-08
Mailing Address10 Wisteria Dr Apt 3c
Fords, NJ 08863-1130
United States
Phone: (917) 742-8669
📍 View Map
Primary Practice Address1468 Madison Ave
New York, NY 10029-6508
United States
Phone: (212) 241-1314
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes163WG0000X – Registered Nurse, General PracticeNY491143
No363LF0000X – Nurse Practitioner, FamilyNYF355613-01
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About NPI 1114733417

Tenesha Shanta Kelly-Roberts FNP-C is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1114733417. The primary specialty listed is Registered Nurse, General Practice. The provider is located in New York, NY. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2024-12-10. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1114733417?

NPI 1114733417 belongs to Tenesha Shanta Kelly-Roberts FNP-C, a Registered Nurse, General Practice in New York, NY. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1114733417 active?

The current status of NPI 1114733417 in the NPPES registry is Active. The record was last updated on 2026-05-08.

What specialty is NPI 1114733417?

NPI 1114733417 is classified under the taxonomy Registered Nurse, General Practice. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1114733417?

You can verify NPI 1114733417 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1114733417?

The primary practice address on file for NPI 1114733417 is 1468 Madison Ave, New York, NY 10029-6508. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1114733417 issued?

NPI 1114733417 was first issued (enumerated) on 2024-12-10. The NPPES record was last updated on 2026-05-08.

Practice Location Map

Tenesha Shanta Kelly-Roberts is located at 1468 Madison Ave, New York, NY. Use the map below to find directions or verify the practice location.

📍 1468 Madison Ave, New York, NY 10029-6508  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Tenesha Shanta Kelly-Roberts. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1114733417. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Registered Nurse, General Practice491143NY
Nurse Practitioner, FamilyF355613-01NY
Data Verified from CMS NPPES Last synced: 2026-08-13 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162