Individual provider Active NPI

Kerry Timmins Standley, NP

  • Family Nurse Practitioner
  • Kinston, NC
National Provider Identifier
1154889830
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5011572 Issued in NC
Practice address
2100 Presbyterian LN
Kinston, NC 28501-2266
Phone
(252) 208-7784
Fax
(919) 580-7010
NPI assigned
Mar 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 5011572 NC
Family Nurse Practitioner 363LF0000X 5011572 NC Primary

Addresses

Primary practice location

2100 Presbyterian LN
Kinston, NC 28501-2266

Mailing address

2100 Presbyterian LN
Kinston, NC 28501-2266
Phone (252) 208-7784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190520002865 NC Practitioner - Nurse Practitioner 3577806223

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2100 Olresbtteruab Lane
Kinston, NC 28501-2266

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.38 of 100Reported as group
Quality
88.76
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5011572NCMDFamily Nurse Practitioner

Hospital & facility affiliations 2

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": "1552348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1154889830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 PRESBYTERIAN LN",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285012266",
            "telephone_number": "252-208-7784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 PRESBYTERIAN LN",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285012266",
            "telephone_number": "252-208-7784",
            "fax_number": "919-580-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANDLEY",
        "first_name": "KERRY",
        "middle_name": "TIMMINS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-12",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NC",
            "license": "5011572",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5011572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kinston, NC

Sources for this page

Verify at the official NPI Registry.