Kelly Merrill Selby, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APRN9451513 Issued in FL

Practice address

1600 SW Archer Rd
Box 100254
Gainesville, FL 32610-0254

Phone

(352) 273-8610

NPI assigned

Jan 23, 2017

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 1

Other names 1

• Kelly Nicole Merrill Former name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Clinical Practice Association IncGroup PAC ID 0345146254, 1,886 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017

Merit-based Incentive Payment System (MIPS)

Final score

47.54 of 100Reported as apm

Quality

38.49

Promoting interoperability

0

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Florida Clinical Practice Association Inc

  dba UF Health Physicians

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768
  Medicare reassignment Care Compare group NPD
• Orange City Anesthesia Services LLC

  • Anesthesiology Physician
  • Orange City, FL
  • NPI 1972882314
  Medicare reassignment NPD
• Space Coast Anesthesia Services LLC

  • Anesthesiology Physician
  • Merritt Island, FL
  • NPI 1942441753
  Medicare reassignment NPD
• Anesthesiology Professional Services, Inc.

  • Anesthesiology Physician
  • Tampa, FL
  • NPI 1902856891
  NPD
• Florida Clinical Practice Association Inc

  dba UF Health Family Medicine Ocala Heath Brook

  • Durable Medical Equipment & Medical Supplies
  • Ocala, FL
  • NPI 1609529478
  NPD
• Lake Mary Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Lake Mary, FL
  • NPI 1174530752
  NPD

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

• Halifax Hospital Medical Center

  dba Halifax Medical Center

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1811991227
  Care Compare affiliation

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1326585720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "address_2": "BOX 100254",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100254",
            "telephone_number": "352-273-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "address_2": "BOX 100254",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100254",
            "telephone_number": "352-273-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELBY",
        "first_name": "KELLY",
        "middle_name": "MERRILL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-23",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9451513",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN9451513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019871000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MERRILL",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tyler Loren Seidman
• Robert Patrick Seifert, M.D.
• Matt Seitz, PHD
• McKenzie Katherine Seitz, MD
• Stephen Seitz, PA
• Select Physical Therapy Holdings Inc
• Select Specialty Hospital Gainesville LLC
• Select Specialty Hospital Gainesville LLC
• Khalil Adel Selim
• Judith Selle

• Certified Registered Nurse Anesthetist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.