Kellie Planck

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71006172A Issued in IN

Practice address

4781 Kaybee Drive
Gas City, IN 46933-6607

Phone

(765) 660-7840

Fax

(765) 671-3509

NPI assigned

Feb 25, 2016

Last updated

Oct 20, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marion General HospitalGroup PAC ID 9133023625, 115 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Angels of Mercy Homecare Home health agency, Marion, IN, CCN 157554
• Marion General Hospital Hospital, Marion, IN, CCN 150011

Merit-based Incentive Payment System (MIPS)

Final score

85.82 of 100Reported as group

Quality

71.45

Promoting interoperability

100

Improvement activities

40

Cost

75.59

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kellie.planck@mgh.eclinicaldirectplus.com

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.

• Marion General Hospital

  dba Physicians' Billing of MGH

  • Family Medicine Physician
  • Marion, IN
  • NPI 1528099041
  Medicare reassignment Care Compare group NPD
• Marion General Hospital

  • General Acute Care Hospital
  • Gas City, IN
  • NPI 1760186373
  NPD

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

• In Homecare Network North, LLC

  dba Angels of Mercy

  • Home Health Agency
  • Marion, IN
  • NPI 1265872972
  Care Compare affiliation
• Marion General Hospital

  • General Acute Care Hospital
  • Gas City, IN
  • NPI 1760186373
  Care Compare affiliation
• Marion General Hospital

  • General Acute Care Hospital
  • Marion, IN
  • NPI 1770679201
  Care Compare affiliation
• Marion General Hospital

  dba Marion General Hospital Nutritional Support

  • Nutrition Support Registered Nurse
  • Marion, IN
  • NPI 1861578072

  Hospital

  Care Compare affiliation
• Marion General Hospital

  dba Marion General Hospital Ambulance Service

  • Land Ambulance
  • Marion, IN
  • NPI 1932295466

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1144680679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N WABASH",
            "address_2": "STE G20",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522600",
            "telephone_number": "765-660-7616",
            "fax_number": "765-651-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4781 KAYBEE DRIVE",
            "city": "GAS CITY",
            "state": "IN",
            "postal_code": "469336607",
            "telephone_number": "765-660-7840",
            "fax_number": "765-671-3509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLANCK",
        "first_name": "KELLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-25",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71006172A",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006172A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "0000001008936",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201358080",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kellie.planck@mgh.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "4781 Kaybee Drive",
            "city": "Gas City",
            "state": "IN",
            "country_code": "US",
            "postal_code": "469336607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mississinewa Community School District
• Jenifer Myers
• Orthopaedics-Indianapolis, Inc
• Personal Care Concepts Plus, Inc.
• Physicians' Billing of MGH (Mississinewa Medical Center, Dr. Lori Fuqua)
• Teryn Jane Renbarger, M.A., CCC-SLP
• Mitchell Ridgway
• Shyanna Robison
• Madisen Paige Rodarte, MSW
• Payton Michael Scott, PT, DPT, LAT, AC

• Nurse Practitioner in Gas City, IN
• Providers in Gas City, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.