Kelly Llewellyn, CRNP, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R143168 Issued in MD

Practice address

9093 Ridgefield Dr
#104
Frederick, MD 21701-6710

Phone

(301) 682-4100

Fax

(301) 682-9100

NPI assigned

Nov 4, 2013

Last updated

Aug 2, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD

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

Frederick Health Medical Group LLCGroup PAC ID 9931341096, 200 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bayada Home Health Care, Inc Home health agency, Gaithersburg, MD, CCN 217158
• Frederick Health Hospice Hospice, Frederick, MD, CCN 211516
• Frederick Health Hospital Hospital, Frederick, MD, CCN 210005

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Frederick Health Medical Group LLC

  dba Frederick Health Medical Group

  • Family Medicine Physician
  • Frederick, MD
  • NPI 1619258225
  Medicare reassignment Care Compare group NPD
• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  MD

  Medicare reassignment NPD
• Frederick Health Medical Group LLC

  • Family Medicine Physician
  • Mount Airy, MD
  • NPI 1114771862
  NPD
• Frederick Health Medical Group LLC

  dba Center for Breast Care

  • Surgery Physician
  • Frederick, MD
  • NPI 1770850547
  NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

• Bayada Home Health Care, Inc.

  • Home Health Agency
  • Gaithersburg, MD
  • NPI 1902149891
  Care Compare affiliation
• Frederick Health Hospital Inc

  dba Frederick Health Hospice

  • Community Based Hospice Care Agency
  • Frederick, MD
  • NPI 1205832268
  Care Compare affiliation
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  Care Compare affiliation

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1336578947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9115 SYCAMORE CT",
            "city": "UNION BRIDGE",
            "state": "MD",
            "postal_code": "217917560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9093 RIDGEFIELD DR",
            "address_2": "#104",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217016710",
            "telephone_number": "301-682-4100",
            "fax_number": "301-682-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLEWELLYN",
        "first_name": "KELLY",
        "credential": "CRNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R143168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "926580508",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "926580505",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lives Savers Behavioral Health LLC (Lives Savers Behavioral Health)
• Living Well Center
• Living Well LLC
• Joseph Sean Livingston, MD
• Wilson A Llerena, LGMFT
• Rachael Jeanette Llewellyn
• Jasmine Nicole Lloyd, LMSW
• Yasmin I Lluveras, LCSW-C
• Issa Tew Lo, CRNP
• Ashleigh Lobalbo, PA

• Family Nurse Practitioner in Frederick, MD
• Providers in Frederick, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; 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.