Individual provider Active NPI

Kelli L Gramlich

  • Critical Care Medicine Nurse Practitioner
  • Atlantic City, NJ
National Provider Identifier
1134768419
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
26NJ00995700 Issued in NJ
Practice address
1925 Pacific Ave
Atlantic City, NJ 08401-6713
Phone
(609) 441-8023
NPI assigned
Jan 3, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X 26NJ00995700 NJ Primary

Addresses

Primary practice location

1925 Pacific Ave
Atlantic City, NJ 08401-6713

Mailing address

1925 Pacific Ave
Atlantic City, NJ 08401-6713
Phone (609) 441-8023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20200128002786 NJ Practitioner - Nurse Practitioner 7113353830 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlanticare Physician Group PAGroup PAC ID 8527953660, 506 clinicians

Practice addresses (Care Compare)

1925 Pacific Ave
Atlantic City, NJ 08401-6713
Phone (609) 441-8146

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00995700NJMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Regional Medical Center Acute Care CurrentSince Jul 2, 2021 Accepting new patients
Atlanticare Physician Group, PA CurrentSince Jan 5, 2020 Accepting new patients
Atlanticare Physician Group PA CurrentSince Jan 5, 2020 Accepting new patients
Atlanticare Regional Medical Center CurrentSince Jul 2, 2021 Accepting new patients

Locations

1925 Pacific Ave
Atlantic City, NJ 08401
Phone (609) 441-8023

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

65 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 484-6414

Organizations & group practices 4

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": "1578009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1134768419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 PACIFIC AVE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084016713",
            "telephone_number": "609-441-8023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 PACIFIC AVE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084016713",
            "telephone_number": "609-441-8023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMLICH",
        "first_name": "KELLI",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-03",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "NJ",
            "license": "26NJ00995700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantic City, NJ

Sources for this page

Verify at the official NPI Registry.