Individual provider Active NPI

Kelley Veronica Cross, ARNP

  • Family Nurse Practitioner
  • Maitland, FL
National Provider Identifier
1003250234
Registry record updated Apr 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9356035 Issued in FL
Practice address
301 N Maitland Ave
Maitland, FL 32751-4723
Phone
(407) 647-5996
Fax
(407) 644-5967
NPI assigned
Apr 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9356035 FL Primary

Addresses

Primary practice location

301 N Maitland Ave
Maitland, FL 32751-4723

Mailing address

301 N Maitland Ave
Maitland, FL 32751-4723
Phone (407) 647-5996

Other identifiers 1

IdentifierTypeStateIssuer
279688100MedicaidFL

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

State licenses

LicenseStateTypeSpecialty
9356035FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Associates, PA PastSince Dec 18, 2012 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1366243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1003250234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N MAITLAND AVE",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514723",
            "telephone_number": "407-647-5996",
            "fax_number": "407-644-5967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N MAITLAND AVE",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514723",
            "telephone_number": "407-647-5996",
            "fax_number": "407-644-5967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSS",
        "first_name": "KELLEY",
        "middle_name": "VERONICA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-18",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9356035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279688100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.