Individual provider Active NPI

Kelly Fusco, PMHNP BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Akron, OH
National Provider Identifier
1043759459
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRNCNP0027901 Issued in OH
Practice address
611 W Market St
Akron, OH 44303-1411
Phone
(330) 996-4600
Fax
(330) 564-9296
NPI assigned
Feb 17, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X RN355706 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRNCNP0027901 OH Primary

Addresses

Primary practice location

611 W Market St
Akron, OH 44303-1411

Mailing address

611 W Market St
Akron, OH 44303-1411
Phone (330) 996-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20210322001774 OH Practitioner - Nurse Practitioner 6204243165 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN355706OHMDChild & Adolescent Psychiatric/Mental Health Registered Nurse
APRNCNP0027901OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family & Community Services Inc CurrentSince Feb 11, 2022 Accepting new patients
Axess Family Services Inc CurrentSince May 12, 2024 Accepting new patients
Family & Community Services, Inc CurrentSince Feb 11, 2022 Accepting new patients
Axess Family Services Inc CurrentSince May 12, 2024 Accepting new patients
Axess Family Services Inc Current Accepting new patients

Locations

1400 S Arlington St
Unit 38
Akron, OH 44306
Phone (330) 724-5471

390 Robinson Ave
Ste E
Barberton, OH 44203
Phone (330) 564-2697

143 Gougler Ave
Kent, OH 44240
Phone (330) 673-1016

771 N Freedom St
Ravenna, OH 44266
Phone (330) 296-5552

5968 New Milford Rd
Ravenna, OH 44266

150 E Market St
Warren, OH 44481
Phone (330) 394-6244

318 Mahoning Ave NW
Warren, OH 44483
Phone (330) 394-6342

4970 Belmont Ave
Youngstown, OH 44505
Phone (330) 759-8237

Organizations & group practices 5

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": "1487289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1043759459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W MARKET ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443031411",
            "telephone_number": "330-996-4600",
            "fax_number": "330-564-9296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W MARKET ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443031411",
            "telephone_number": "330-996-4600",
            "fax_number": "330-564-9296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSCO",
        "first_name": "KELLY",
        "credential": "PMHNP BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-17",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "OH",
            "license": "RN355706",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRNCNP0027901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.