Individual provider Active NPI

Kelsey Lena Craver, MD

  • Emergency Medicine Physician
  • Winston Salem, NC
National Provider Identifier
1114487691
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2022-00739 Issued in NC
Practice address
1 Medical Center Boulevard
Winston Salem, NC 27157-5812
Phone
(336) 713-9200
NPI assigned
Mar 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 250210 NC
Emergency Medicine Physician 207P00000X 2022-00739 NC Primary

Addresses

Primary practice location

1 Medical Center Boulevard
Winston Salem, NC 27157-5812

Mailing address

1 Medical Center Boulevard
Winston Salem, NC 27157-0001

Other names 1

  • Kelsey Marie Lena Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240715002302 GA Practitioner - Emergency Medicine 3779811179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Texas Medical Branch at Galveston, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Emergency Department Services, P.C.Group PAC ID 5597751032, 76 clinicians

Practice addresses (Care Compare)

743 Spring Nest
Gainesville, GA 30501-3715
Phone (770) 503-3000

Hospital & facility affiliations

  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
  • Northeast Georgia Medical Center Habersham Hospital, Demorest, GA, CCN 110041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2022-00739NCMDEmergency Medicine Physician
250210NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Emergency Department Services, P.C. Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients

Locations

1400 River Pl
Braselton, GA 30517
Phone (770) 219-6000

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

Organizations & group practices 1

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": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1114487691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BOULEVARD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BOULEVARD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271575812",
            "telephone_number": "336-713-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAVER",
        "first_name": "KELSEY",
        "middle_name": "LENA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-21",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "250210",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2022-00739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "LENA",
            "middle_name": "MARIE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.