Individual provider Active NPI

Chrystal Leanette Kelmanson, APRN

  • Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1265982961
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3010778 Issued in KY
Practice address
6420 Dutchmans Pkwy Ste 200
Louisville, KY 40205-3373
Phone
(502) 891-8300
Fax
(502) 891-8338
NPI assigned
Oct 6, 2016
Last updated
Oct 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3010778 KY Primary

Addresses

Primary practice location

6420 Dutchmans Pkwy Ste 200
Louisville, KY 40205-3373

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cjustice163843@direct.nortonhealthcare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3010778KYMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: cjustice163843@direct.nortonhealthcare.org

NPI Registry JSON

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1265982961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 DUTCHMANS PKWY STE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402053373",
            "telephone_number": "502-891-8300",
            "fax_number": "502-891-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELMANSON",
        "first_name": "CHRYSTAL",
        "middle_name": "LEANETTE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-06",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3010778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cjustice163843@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "6420 Dutchmans Pkwy Ste 200",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402053373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.