Individual provider Active NPI

Kelly Anna Fetterhoff, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Harrisburg, PA
National Provider Identifier
1316556566
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP022261 Issued in PA
Practice address
205 S Front St
Harrisburg, PA 17104-1619
Phone
(717) 231-8360
NPI assigned
Jul 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP022261 PA Primary

Addresses

Primary practice location

205 S Front St
Harrisburg, PA 17104-1619

Mailing address

205 S Front St
Harrisburg, PA 17104-1619
Phone (717) 231-8360

Other names 1

  • Kelly Anna Fetterhoff Former name

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
I20200827000025 PA Practitioner - Nurse Practitioner 5890112544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Medical ServicesGroup PAC ID 7618960493, 1,025 clinicians

Practice addresses (Care Compare)

205 S Front St
5TH
Harrisburg, PA 17104-1619
Phone (717) 231-8360

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.08 of 100Reported as group
Quality
76.48
Promoting interoperability
100
Improvement activities
40
Cost
77.12

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services Current Accepting new patients
Pinnacle Health Medical Services CurrentSince Sep 8, 2020 Accepting new patients
Pinnacle Health Medical Services CurrentSince Sep 8, 2020 Accepting new patients

Locations

205 S Front St
Harrisburg, PA 17104
Phone (717) 231-8360

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

205 S Front St
Fl 5
Harrisburg, PA 17104
Phone (717) 231-8360

Interoperability endpoints

  • Direct secure messaging: kfetterhoff287156@upmc.direct-ci.com

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 7

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": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789689600000",
    "number": "1316556566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S FRONT ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041619",
            "telephone_number": "717-231-8360",
            "fax_number": "717-231-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S FRONT ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041619",
            "telephone_number": "717-231-8360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OXENDINE",
        "first_name": "KELLY",
        "middle_name": "ANNA",
        "name_prefix": "Miss",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP022261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "FETTERHOFF",
            "middle_name": "ANNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.