NPIMap

Individual provider Active NPI

Kelly Crews, ARNP

  • Pediatric Nurse Practitioner
  • Lakeland, FL
National Provider Identifier
1033126412
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
ARNP9170779 Issued in FL
Practice address
601 S Florida Ave
Suite 6
Lakeland, FL 33801-5237
Phone
(863) 688-0841
Fax
(863) 616-9709
NPI assigned
Aug 1, 2006
Last updated
Nov 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X ARNP9170779 FL Primary

Addresses

Primary practice location

601 S Florida Ave
Suite 6
Lakeland, FL 33801-5237

Mailing address

601 S Florida Ave
#6
Lakeland, FL 33801-5237
Phone (863) 688-0841

Other identifiers 2

IdentifierTypeStateIssuer
305346600MedicaidFL
ARNP 9170779OtherFLARNP LICENSE NUMBER

Other names 1

  • Kelly Stewart Former name

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9170779FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Health Care, Inc. Past Accepting new patients
Central Florida Health Care, Inc. Past Accepting new patients
Central Florida Health Care, Inc. Past Accepting new patients
Central Florida Health Care, Inc Past Accepting new patients
Central Florida Health Care Inc Past Accepting new patients
Central Florida Health Care, Inc. Past Accepting new patients
Central Florida Health Care, Inc. Past Accepting new patients
Central Florida Health Care Inc Past Accepting new patients
Central Florida Health Care, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kelly.crews.1@12125.direct.athenahealth.com

Organizations & group practices 9

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

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1033126412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S FLORIDA AVE",
            "address_2": "#6",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015237",
            "telephone_number": "863-688-0841",
            "fax_number": "863-616-9709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S FLORIDA AVE",
            "address_2": "SUITE 6",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015237",
            "telephone_number": "863-688-0841",
            "fax_number": "863-616-9709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREWS",
        "first_name": "KELLY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP9170779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305346600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP LICENSE NUMBER",
            "identifier": "ARNP 9170779",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "STEWART",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; 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.