Individual provider Active NPI

Kelly R. Haikes, CRNP

  • Nurse Practitioner
  • Scranton, PA
National Provider Identifier
1003885435
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
VP005115B Issued in PA
Practice address
531 Mt Pleasant Dr
Scranton, PA 18503-1987
Phone
(570) 342-8500
Fax
(570) 342-0924
NPI assigned
Mar 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN325220L PA
Nurse Practitioner 363L00000X VP005115B PA Primary

Addresses

Primary practice location

531 Mt Pleasant Dr
Scranton, PA 18503-1987

Mailing address

100 N Academy Ave
Credentials Dept
Danville, PA 17822-4903
Phone (570) 271-6144

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address khaikes72564@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050211000531 PA Practitioner - Nurse Practitioner 2567414113 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

531 Mt Pleasant Dr
Scranton, PA 18503-1987
Phone (570) 342-8500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN325220LPAMDRegistered Nurse
VP005115BPAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger-HM Joint Venture, LLC Nurse Practitioner CurrentSince Mar 22, 2021 Accepting new patients
Geisinger Clinic CurrentSince Jun 4, 1998 Accepting new patients
Geisinger Clinic Nurse Practitioner Current Accepting new patients
Geisinger Clinic CurrentSince Jun 4, 1998 Accepting new patients
Geisinger-HM Joint Venture, LLC Nurse Practitioner CurrentSince Mar 22, 2021 Accepting new patients
Geisinger Clinic Past Accepting new patients
Caring Community Health Center Past Accepting new patients

Locations

226 Buckaroo Ln
Bellefonte, PA 16823
Phone (814) 353-1030

174 Buckaroo Ln
Bellefonte, PA 16823
Phone (814) 353-1030

425 E 1st St
Bloomsburg, PA 17815
Phone (570) 387-2474

224 N Logan Blvd
Burnham, PA 17009
Phone (717) 242-0196

100 N Academy Ave
Danville, PA 17822

68 Spring St
Lock Haven, PA 17745
Phone (570) 263-5830

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

4004 Birney Ave
Moosic, PA 18507
Phone (570) 344-4711

126 Market Way
Mount Pocono, PA 18344
Phone (570) 839-3633

12 Kirby Ave
Mountain Top, PA 18707
Phone (570) 474-5978

57 N Main St
Pittston, PA 18640
Phone (570) 602-5620

531 Mt Pleasant Dr
Scranton, PA 18503
Phone (570) 342-8500

125 Scranton Pocono Hwy
Scranton, PA 18505
Phone (570) 342-8500

3 W Olive St
Scranton, PA 18508
Phone (570) 207-4054

1020 Northern Blvd
South Abington Township, PA 18411
Phone (570) 587-2290

631 Northern Blvd
South Abington Township, PA 18411
Phone (570) 340-6920

1630 N Atherton St
State College, PA 16803
Phone (814) 238-1279

1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300

50 Roosevelt Ter
Wilkes Barre, PA 18702
Phone (570) 808-8780

1824 E 3rd St
Williamsport, PA 17701
Phone (570) 322-4422

Interoperability endpoints

  • Direct secure messaging: khaikes72564@direct.geisinger.edu

Organizations & group practices 7

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1003885435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "address_2": "CREDENTIALS DEPT",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 MT PLEASANT DR",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185031987",
            "telephone_number": "570-342-8500",
            "fax_number": "570-342-0924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIKES",
        "first_name": "KELLY",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN325220L",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "VP005115B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khaikes72564@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "531 Mt Pleasant Dr",
            "city": "Scranton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "185031987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.