Individual provider Active NPI

Kaylie Crump

  • Family Nurse Practitioner
  • Summerville, GA
National Provider Identifier
1124885058
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN286981 Issued in GA
Practice address
11766 Highway 27
Summerville, GA 30747-5989
Phone
(706) 857-1010
NPI assigned
Mar 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN286981 GA Primary

Addresses

Primary practice location

11766 Highway 27
Summerville, GA 30747-5989

Mailing address

11766 Highway 27
Summerville, GA 30747-5989

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240703001739 GA Practitioner - Nurse Practitioner 7315481165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Floyd Healthcare Management IncGroup PAC ID 5193633386, 133 clinicians

Practice addresses (Care Compare)

11766 Hwy 27
Summerville, GA 30747-5989
Phone (706) 857-3915

Hospital & facility affiliations

  • Atrium Health Floyd Medical Center Hospital, Rome, GA, CCN 110054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN286981GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd Healthcare Management Inc Family CurrentSince May 6, 2024 Accepting new patients
Floyd Healthcare Management Inc CurrentSince May 6, 2024 Accepting new patients

Locations

251 Highway 53 E
Calhoun, GA 30701
Phone (706) 602-8200

1025 N Main St
Cedartown, GA 30125
Phone (770) 748-5212

420 E 2nd Ave
Ste 103
Rome, GA 30161
Phone (706) 509-3278

11766 Highway 27
Summerville, GA 30747
Phone (706) 857-1010

Interoperability endpoints

  • Direct secure messaging: kcrump2740255@carolinashealthcaresystem.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1709683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1124885058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11766 HIGHWAY 27",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "307475989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11766 HIGHWAY 27",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "307475989",
            "telephone_number": "706-857-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMP",
        "first_name": "KAYLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN286981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, GA

Sources for this page

Verify at the official NPI Registry.