Individual provider Active NPI

Kelly Colleen Herms, CRNA

  • Certified Registered Nurse Anesthetist
  • Palm City, FL
National Provider Identifier
1083920714
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
11015969 Issued in FL
Practice address
4932 SW Bimini Cir N
Palm City, FL 34990-1232
Phone
(810) 434-2909
NPI assigned
Aug 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704265066 MI
Certified Registered Nurse Anesthetist 367500000X 4704265066 MI
Certified Registered Nurse Anesthetist 367500000X 11015969 FL Primary

Addresses

Primary practice location

4932 SW Bimini Cir N
Palm City, FL 34990-1232

Mailing address

4932 SW Bimini Cir N
Palm City, FL 34990-1232
Phone (810) 434-2909

Other names 1

  • Kelly Knust Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101230000655 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 7214125574 Reassigns benefits to 2 organizations
I20220426001304 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7214125574 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hurley Medical CenterGroup PAC ID 2961308481, 336 clinicians
Treasure Coast Anesthesia Group PAGroup PAC ID 2567600588, 98 clinicians

Practice addresses (Care Compare)

1 Hurley PLZ
Flint, MI 48503-5902
Phone (810) 262-9353

200 SE Hospital Ave
Stuart, FL 34994-2346
Phone (772) 287-5200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704265066MIMDRegistered Nurse
11015969FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Hurley Medical Center CurrentSince Oct 25, 2010 Accepting new patients
Florida Eye Institute Surgicenter LLC CurrentSince Aug 2, 2023 Accepting new patients
Fpra Anesthesia Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2022 Accepting new patients
Treasure Coast Anesthesia Group PA Nurse Anesthetist, Certified Registered CurrentSince May 1, 2022 Accepting new patients
Hurley Medical Center Nurse Anesthetist, Certified Registered CurrentSince Oct 25, 2010 Accepting new patients
Chelsea Community Hospital Nurse Anesthetist, Certified Registered CurrentSince Dec 6, 2020 Accepting new patients
Chelsea Community Hospital CurrentSince Dec 6, 2020 Accepting new patients
Florida Eye Institute Surgicenter LLC Past Accepting new patients
National Surgical Centers of America LLC PastSince Jul 1, 2022 Accepting new patients

Locations

150 SW Chamber Ct
Ste 104
Port St Lucie, FL 34986
Phone (772) 879-5300

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

13945 N US Highway 441
The Villages, FL 32159
Phone (352) 277-3500

2750 Indian River Blvd
Vero Beach, FL 32960
Phone (561) 569-9500

1693 Lee Rd
Ste A
Winter Park, FL 32789
Phone (407) 287-4300

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1282089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1083920714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4932 SW BIMINI CIR N",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349901232",
            "telephone_number": "810-434-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4932 SW BIMINI CIR N",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349901232",
            "telephone_number": "810-434-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMS",
        "first_name": "KELLY",
        "middle_name": "COLLEEN",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-18",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704265066",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704265066",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "11015969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "KNUST",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Palm City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.