Kelly Footen, FNP-C

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R169068 Issued in MD

Practice address

1141 Opal CT
Hagerstown, MD 21740-5976

Phone

(301) 791-6666

NPI assigned

Feb 19, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17459/brand/1/csg/1/fhir/r4
• Direct secure messaging: kelly.footen.1@17459.direct.athenahealth.com

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Opal Court Pediatrics, P.a.

  • Pediatrics Physician
  • Hagerstown, MD
  • NPI 1649235888

  Single Specialty

  NPD (past)
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD (past)

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710633600000",
    "number": "1194580233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14555 FAIRVIEW HILL LN",
            "city": "CLEAR SPRING",
            "state": "MD",
            "postal_code": "217221249",
            "telephone_number": "301-748-7341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 OPAL CT",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405976",
            "telephone_number": "301-791-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOOTEN",
        "first_name": "KELLY",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-03-17",
        "certification_date": "2024-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R169068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylee Folmer, LMSW
• Sylvie Mah Fon, NP
• Sylvia Ngum Fondikum
• Brooke Foor
• Foot and Ankle Specialists of the Mid-Atlantic, LLC
• Forbs Behavioral Health Services LLC
• Amy J Foreman, PTA
• Forma Care Services
• Yvonne L Fornishi, RPH
• Katherine Ann Forrest, LCSW-C

• Pediatric Nurse Practitioner in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Pediatric Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2024; 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.