Christy Kelley, N.P

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209009607 Issued in IL

Practice address

205 East Huron St.
Irvington, IL 62848

Phone

(618) 249-6203

Fax

(618) 249-6263

NPI assigned

Jul 18, 2012

Last updated

Jul 18, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Medical and Occupational Services SCGroup PAC ID 3476794496, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Regional HLTH Center Hospital, Mount Vernon, IL, CCN 140046

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Midwest Medical and Occupational Services SC

  dba Express Care of Mt Vernon

  • Emergency Medicine Physician
  • Mount Vernon, IL
  • NPI 1679814305
  Medicare reassignment Care Compare group NPD
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Good Samaritan Regional Health Center

  dba SSM Health Good Samaritan Hospital - Mt. Vernon

  • General Acute Care Hospital
  • Mount Vernon, IL
  • NPI 1609897339
  Care Compare affiliation

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1053666792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19841 N IRIS LN",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628648832",
            "telephone_number": "618-315-0153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 EAST HURON ST.",
            "city": "IRVINGTON",
            "state": "IL",
            "postal_code": "62848",
            "telephone_number": "618-249-6203",
            "fax_number": "618-249-6263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "CHRISTY",
        "credential": "N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209009607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bandys Apothecary Shops, Inc (Bandy's Pharmacy II)
• Nora Fitzgerald, RN
• Irvington CC SCH Dist 11
• Jerry L. Beguelin, MD, PC (Irvington Friendly Care, PC)
• Sheree Jones, OT
• Patricia Neudecker, PT, OT
• St. Mary's Hospital
• Rebecca Steinmann, OT
• David Brent Swartzlander, PT

• Family Nurse Practitioner in Irvington, IL
• Providers in Irvington, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.