Kelly Kristine Parish-Larson, RN, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5377-33 Issued in WI

Practice address

3500 Tower Ave
Essentia Health St. Mary's Superior Clinic
Superior, WI 54880-5335

Phone

(715) 395-5454

NPI assigned

Jun 18, 2013

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

Other identifiers 2

Other names 1

• Kelly Kristine Parish Former name

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Marys Hospital of SuperiorGroup PAC ID 8628964228, 96 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Marys Hospital Superior Hospital, Superior, WI, CCN 521329
• Essentia Health St Mary's Medical Center Hospital, Duluth, MN, CCN 240002

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• St. Mary's Hospital of Superior

  dba Essentia Health St. Mary's Hospital Superior

  • Critical Access Hospital
  • Superior, WI
  • NPI 1083657886
  Medicare reassignment Care Compare group NPD
• St. Mary's Duluth Clinic Health System

  • Clinical Medical Laboratory
  • Superior, WI
  • NPI 1205866928
  NPD
• St. Mary's Hospital of Superior

  dba Essentia Health St. Mary's-Superior Clinic

  • Critical Access Hospital Clinic/Center
  • Superior, WI
  • NPI 1588691588
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Mary's Hospital of Superior

  dba Essentia Health St. Mary's Hospital Superior

  • Critical Access Hospital
  • Superior, WI
  • NPI 1083657886
  Care Compare affiliation
• St. Mary's Hospital of Superior

  dba Essentia Health St. Mary's-Superior Clinic

  • Critical Access Hospital Clinic/Center
  • Superior, WI
  • NPI 1588691588
  Care Compare affiliation
• St Marys Medical Center

  dba Essentia Health St Marys Medical Center

  • General Acute Care Hospital
  • Duluth, MN
  • NPI 1457393035
  Care Compare affiliation
• St. Marys Medical Center

  dba SMMC Life Flight

  • Air Ambulance
  • Duluth, MN
  • NPI 1841359478

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1316386998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 TOWER AVE",
            "address_2": "ESSENTIA HEALTH ST. MARY'S SUPERIOR CLINIC",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548805335",
            "telephone_number": "715-395-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 TOWER AVE",
            "address_2": "ESSENTIA HEALTH ST. MARY'S SUPERIOR CLINIC",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548805335",
            "telephone_number": "715-395-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARISH-LARSON",
        "first_name": "KELLY",
        "middle_name": "KRISTINE",
        "credential": "RN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-18",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "193379-30",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "5377-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316386998",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316386998",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "PARISH",
            "middle_name": "KRISTINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Superior, WI
• Providers in Superior, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.