Kristina Faye Kelley

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5014880 Issued in NC

Practice address

7201 US Highway 64 E
Knightdale, NC 27545-9268

Phone

(919) 266-7600

NPI assigned

Aug 11, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1194490292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 US HIGHWAY 64 E",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275459268",
            "telephone_number": "919-266-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7201 US HIGHWAY 64 E",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275459268",
            "telephone_number": "919-266-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "KRISTINA",
        "middle_name": "FAYE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "279140",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5014880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kapital Connections, LLC
• Lydia Gorrette Katikiri
• Kelli Eileen Keaton, DPT
• Jennifer Upchurch Keene, MSW, LCSWA
• Jeffrey M Keil, MD
• Tracy Wogan Kendrick, M.D.
• Jacqueline Farber Kerkow
• Kevin Chidester, D.M.D., P.L.L.C.
• Razu Khan, NP
• Jasmine Nichole Kight

• Family Nurse Practitioner in Knightdale, NC
• Providers in Knightdale, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.