Kaeai Edgerly, NP-C, APRN

Key facts

NPI

1124547666

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

APRN002623 (NV)

Practice address

55 Damonte Ranch Pkwy
Reno, NV 89521-2996

Phone

(845) 249-5500

NPI assigned

Sep 15, 2017

Sex

Female

Sole proprietor

No

Organizations & group practices 2

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.

• CTH Physicians Clinic Internal Medicine Physician · Carson City, NV · NPI 1306533732
  Medicare reassignment Care Compare group NV
• Santibanez Pac Nevada Geriatric Medicine (Internal Medicine) Physician · Carson City, NV · NPI 1174398770
  Medicare reassignment NPD NV

Hospital & facility affiliations 2

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

• Carson Tahoe Regional Healthcare General Acute Care Hospital · Carson City, NV · NPI 1255360160
  Care Compare affiliation Hospital
• Carson Tahoe Regional Healthcare Mental Health Clinic/Center (Including Community Mental Health Center) · Carson City, NV · NPI 1568281988
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CTH Physicians Clinic (107 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carson Tahoe Regional Medical Center Hospital · Carson City, NV · CCN 290019

Merit-based Incentive Payment System (MIPS)

Final score

79.58 of 100 (group)

Quality

71.81

Improvement activities

40

Cost

83.62

Medicare participation

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other names

• Kaeai Carlson Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 9, 2019.

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1124547666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 DAMONTE RANCH PKWY",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895212996",
            "telephone_number": "845-249-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 DAMONTE RANCH PKWY",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895212996",
            "telephone_number": "845-249-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18653 Wedge Pkwy",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895113323",
            "country_code": "US",
            "telephone_number": "775-770-7664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDGERLY",
        "first_name": "KAEAI",
        "credential": "NP-C, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-15",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN002623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAEAI",
            "last_name": "CARLSON",
            "credential": "NP-C, APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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All providers in Reno, NV · Family Nurse Practitioner in Nevada