NPIMap

Individual provider Active NPI

Kelly S. Carr, CRNP

  • Family Nurse Practitioner
  • Lawrenceville, PA
National Provider Identifier
1154344257
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP009074 Issued in PA
Practice address
32 E Lawrence Rd
Lawrenceville Laurel Health Center
Lawrenceville, PA 16929-8801
Phone
(570) 827-0128
Fax
(570) 827-0129
NPI assigned
Jul 26, 2006
Last updated
Jul 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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 SP009074 PA Primary

Addresses

Primary practice location

32 E Lawrence Rd
Lawrenceville Laurel Health Center
Lawrenceville, PA 16929-8801

Mailing address

40 W Wellsboro St
Mansfield, PA 16933-1411
Phone (570) 662-1945

Other identifiers 1

IdentifierTypeStateIssuer
101654306MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061110000196 PA Practitioner - Nurse Practitioner 9638177488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Susquehanna Physician ServicesGroup PAC ID 2264336460, shared by 32 NPIs, 611 clinicians

Practice addresses (Care Compare)

32 E Lawrence Rd
Lawrenceville Laurel HLTH Ctr
Lawrenceville, PA 16929-8801
Phone (570) 827-0125

416 S Main St
Mansfield, PA 16933-1510

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Penn Comprehensive Health Services CurrentSince Aug 7, 2006 Accepting new patients
North Penn Comprehensive Health Services CurrentSince Aug 7, 2006 Accepting new patients
North Penn Comprehensive Health Services Current Accepting new patients
Pratt Medical Center LTD Past Accepting new patients
North Penn Comprehensive Health Services Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
North Penn Comprehensive Health Services Past Accepting new patients

Locations

6 Riverside Plz
Blossburg, PA 16912
Phone (570) 638-2174

103 Forestview Ave
Elkland, PA 16920
Phone (814) 258-5117

32 E Lawrence Rd
Lawrenceville, PA 16929
Phone (570) 827-0125

40 W Wellsboro St
Mansfield, PA 16933
Phone (570) 662-1945

416 S Main St
Mansfield, PA 16933
Phone (570) 662-1900

410 Main St
Ste 102
Towanda, PA 18848
Phone (570) 266-5882

45 Mud Creek Rd
Troy, PA 16947
Phone (570) 297-3746

22 Walnut St
Wellsboro, PA 16901
Phone (570) 723-0621

7 Water St
Wellsboro, PA 16901
Phone (570) 724-1010

236 E Main St
Westfield, PA 16950
Phone (814) 367-5911

Interoperability endpoints

  • Direct secure messaging: kelly.carr@upmcdirect.com

Organizations & group practices 7

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.

Hospital & facility affiliations 12

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1154344257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 W WELLSBORO ST",
            "city": "MANSFIELD",
            "state": "PA",
            "postal_code": "169331411",
            "telephone_number": "570-662-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 E LAWRENCE RD",
            "address_2": "LAWRENCEVILLE LAUREL HEALTH CENTER",
            "city": "LAWRENCEVILLE",
            "state": "PA",
            "postal_code": "169298801",
            "telephone_number": "570-827-0128",
            "fax_number": "570-827-0129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "KELLY",
        "middle_name": "S.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP009074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101654306",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, PA

Sources for this page

Verify at the official NPI Registry.