Individual provider Active NPI

Kelly A Reese, NP

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1104899483
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18046 Issued in SC
Practice address
6439 Garners Ferry Rd
Columbia, SC 29209-1638
Phone
(803) 776-4000
NPI assigned
Feb 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F334655-1 NY
Family Nurse Practitioner 363LF0000X 18046 SC Primary

Addresses

Primary practice location

6439 Garners Ferry Rd
Columbia, SC 29209-1638

Mailing address

136 Goulding Ave
Buffalo, NY 14208-1606
Phone (716) 903-8233

Other identifiers 1

IdentifierTypeStateIssuer
02735160MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, SC, CO3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20060501000062 NY Practitioner - Nurse Practitioner 6709896194 Reassigns benefits to 1 organization
I20130129000628 SC Practitioner - Nurse Practitioner 6709896194 Reassigns benefits to 2 organizations
I20230406000182 CO Practitioner - Nurse Practitioner 6709896194 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F334655-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Jun 1, 2018 Accepting new patients
Signify Health Medical Associates of Colorado, PLLC. CurrentSince Dec 22, 2022 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Current Accepting new patients
Brookview Medical Associates, PLLC CurrentSince Aug 1, 2022 Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Jun 1, 2018 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jan 1, 2022 Accepting new patients
Pulmonary Group of Western New York, LLP PastSince Jul 1, 1993 Accepting new patients
Rpci Oncology PC Past Accepting new patients

Locations

7700 E Arapahoe Rd
Ste 220
Centennial, CO 80112
Phone (303) 285-1148

7900 E Union Ave
Ste 1100
Denver, CO 80237
Phone (469) 466-7420

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

7901 Farrow Rd
Columbia, SC 29203
Phone (803) 734-7846

220 Faison Dr
Columbia, SC 29203
Phone (803) 898-1662

2414 Bull St
Columbia, SC 29201
Phone (803) 898-2461

610 Faison Dr
Columbia, SC 29203
Phone (803) 898-8523

2 Office Park Ct
Ste 103
Columbia, SC 29223
Phone (256) 497-0032

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Interoperability endpoints

  • Direct secure messaging: kreese@hiemail.healtheconnections.org

Organizations & group practices 8

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1104899483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 GOULDING AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142081606",
            "telephone_number": "716-903-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6439 GARNERS FERRY RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292091638",
            "telephone_number": "803-776-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "KELLY",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F334655-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "18046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02735160",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.