Individual provider Active NPI

Kelly S Hammarberg, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lebanon, PA
National Provider Identifier
1326362047
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP013010 Issued in PA
Practice address
239 S Butler Rd
Lebanon, PA 17042-8939
Phone
(717) 273-8871
Fax
(717) 270-2452
NPI assigned
Mar 24, 2010
Last updated
Feb 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP013010 PA Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X RN525635L PA

Addresses

Primary practice location

239 S Butler Rd
Lebanon, PA 17042-8939

Mailing address

785 5TH Ave Ste 3
Chambersburg, PA 17201-4232
Phone (717) 263-9555

Other practice location 1

283 Butler Rd
Mount Gretna, PA 17064-6085
Phone (717) 273-8871

Other practice location 2

283 S Butler Rd
Lebanon, PA 17042-8939
Phone (717) 270-2405

Other practice location 3

283 S Butler Rd
Lebanon, PA 17042-8939
Phone (717) 273-8871

Other identifiers 4

IdentifierTypeStateIssuer
SP013010OtherPASTATE LICENSE - CRNP
SW123688OtherPASTATE LICENSE - SOCIAL WORKER
RN525635LOtherPASTATE LICENSE - RN
102885219MedicaidPA

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
I20131030000143 PA Practitioner - Nurse Practitioner 9234364274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PhilhavenGroup PAC ID 8729991419, 93 clinicians

Practice addresses (Care Compare)

239 S Butler Rd
Lebanon, PA 17042-8939
Phone (717) 270-2422

2501 Oregon Pike
Lancaster, PA 17601-4890
Phone (717) 735-1954

283 S Butler Rd
Lebanon, PA 17042-8939
Phone (717) 270-2422

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN525635LPAMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Philhaven Current Accepting new patients
Philhaven CurrentSince Sep 5, 2013 Accepting new patients
Wellspan Medical Group Past Accepting new patients

Locations

785 5th Ave
Ste 3
Chambersburg, PA 17201

2501 Oregon Pike
Ste 113
Lancaster, PA 17601
Phone (717) 735-1954

204 Hathaway Park
Lebanon, PA 17042
Phone (717) 274-9777

283 S Butler Rd
Lebanon, PA 17042

283 Butler Rd
Mount Gretna, PA 17064
Phone (800) 932-0359

Interoperability endpoints

  • Direct secure messaging: khammarberg53170@wellspan.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1326362047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 5TH AVE STE 3",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014232",
            "telephone_number": "717-263-9555",
            "fax_number": "717-709-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 S BUTLER RD",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170428939",
            "telephone_number": "717-273-8871",
            "fax_number": "717-270-2452"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "283 Butler Rd",
            "address_purpose": "LOCATION",
            "city": "Mount Gretna",
            "state": "PA",
            "postal_code": "170646085",
            "country_code": "US",
            "telephone_number": "717-273-8871",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "283 S Butler Rd",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170428939",
            "country_code": "US",
            "telephone_number": "717-270-2405",
            "fax_number": "717-279-2781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "283 S Butler Rd",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170428939",
            "country_code": "US",
            "telephone_number": "717-273-8871",
            "fax_number": "717-270-2452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMMARBERG",
        "first_name": "KELLY",
        "middle_name": "S",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-24",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP013010",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "PA",
            "license": "RN525635L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE - CRNP",
            "identifier": "SP013010",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE - SOCIAL WORKER",
            "identifier": "SW123688",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE - RN",
            "identifier": "RN525635L",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102885219",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.