Individual provider Active NPI

Kayla Lee Beard, CRNP

  • Pediatric Nurse Practitioner
  • Lititz, PA
National Provider Identifier
1124596721
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
SP019543 Issued in PA
Practice address
1500 Highlands Dr
Lititz, PA 17543-7694
Phone
(717) 568-8865
Fax
(717) 231-8756
NPI assigned
Nov 13, 2018
Last updated
Dec 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP019543 PA
Pediatric Nurse Practitioner 363LP0200X SP019543 PA Primary
Primary Care Nurse Practitioner 363LP2300X SP019543 PA

Addresses

Primary practice location

1500 Highlands Dr
Lititz, PA 17543-7694

Mailing address

1500 Highlands Dr
Lititz, PA 17543-7694
Phone (717) 568-8865

Other practice location 1

2645 N 3rd St
Harrisburg, PA 17110-2001
Phone (717) 782-4650

Other identifiers 1

IdentifierTypeStateIssuer
103603398MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kbeard95278@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20190222001352 PA Practitioner - Nurse Practitioner 3779822531 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP019543PAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince Dec 23, 2024 Accepting new patients
Pinnacle Health Medical Services Current Accepting new patients

Locations

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

1701 Innovation Dr
York, PA 17408
Phone (717) 843-8623

Interoperability endpoints

  • Direct secure messaging: kbeard281296@upmc.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1124596721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 HIGHLANDS DR",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175437694",
            "telephone_number": "717-568-8865",
            "fax_number": "717-231-8756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 HIGHLANDS DR",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175437694",
            "telephone_number": "717-568-8865",
            "fax_number": "717-231-8756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2645 N 3rd St",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171102001",
            "country_code": "US",
            "telephone_number": "717-782-4650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEARD",
        "first_name": "KAYLA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP019543",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP019543",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP019543",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103603398",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbeard95278@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "2645 N 3rd St",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171102001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lititz, PA

Sources for this page

Verify at the official NPI Registry.