Individual provider Active NPI

Kelly J Stoddart, CRNP

  • Family Nurse Practitioner
  • Erie, PA
National Provider Identifier
1275903130
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP015208 Issued in PA
Practice address
1202 State St
Erie, PA 16501-1914
Phone
(814) 454-4530
Fax
(814) 456-2375
NPI assigned
Oct 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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 SP015208 PA Primary

Addresses

Primary practice location

1202 State St
Erie, PA 16501-1914

Mailing address

210 Merline Ave
Erie, PA 16509-1522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20170427000864 PA Practitioner - Nurse Practitioner 5799062808 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Osh - PA Physicians Group, PCGroup PAC ID 7517213879, 113 clinicians
Ars Treatment Centers PCGroup PAC ID 0042568131, 107 clinicians

Practice addresses (Care Compare)

1535 W 26TH St
Suite a
Erie, PA 16508-1357
Phone (814) 314-2315

1611 Peach St
Suite 315
Erie, PA 16501-2122
Phone (800) 805-6989

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP015208PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osh-Mi Physicians Group PC CurrentSince Sep 3, 2025 Accepting new patients
Osh - PA Physicians Group, PC Family CurrentSince Jul 15, 2024 Accepting new patients

Locations

1535 W 26th St
Ste A
Erie, PA 16508
Phone (814) 314-2315

3621 Aramingo Ave
Philadelphia, PA 19134
Phone (312) 600-8484

951 N 6th St
Ste 221
Reading, PA 19601
Phone (484) 207-2000

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1443916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1275903130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 MERLINE AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165091522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 STATE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165011914",
            "telephone_number": "814-454-4530",
            "fax_number": "814-456-2375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STODDART",
        "first_name": "KELLY",
        "middle_name": "J",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-04",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP015208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.