Active NPI
Kelli Ann Gillott, MSN CRNP
- Nurse Practitioner
- Uniontown, PA
National Provider Identifier
1346200375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- SP006394B
- Practice address
- 22 Mill Street
Uniontown, PA 15401 - Phone
- (724) 437-1582
- Fax
- (724) 437-1571
- NPI assigned
- Mar 24, 2006
- Last updated
- May 27, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN512040L | PA | |
| Nurse Practitioner | 363L00000X | SP006394B | PA | Primary |
Addresses
Primary practice location
22 Mill Street
Uniontown, PA 15401
Mailing address
22 Mill Street
Uniontown, PA 15401
Phone (724) 437-1582
Other names 1
- Miss Kelli Ann Koballa
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
323 Sunset Dr
Suite 2
Butler, PA 16001-4017
Phone (724) 282-2730
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN512040L | PA | MD | Registered Nurse |
| SP006394B | PA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adagio Health Inc. | Nurse Practitioner | Current | Accepting new patients |
| Adagio Health Inc. | Current | Accepting new patients | |
| Adagio Health Inc. | Current | Accepting new patients | |
| Windber Hospital, Inc. | Past | Accepting new patients | |
| Adagio Health Inc. | Nurse Practitioner | Past | Accepting new patients |
Locations
323 Sunset Dr
Ste 2
Butler, PA 16001
Phone (724) 282-2730
118 E Plum St
Edinboro, PA 16412
Phone (814) 734-7600
2 Highland Park Dr
Uniontown, PA 15401
Phone (724) 437-1582
205 Easy St
Ste 101
Uniontown, PA 15401
Phone (724) 438-8765
22 Mill St
Uniontown, PA 15401
Phone (724) 437-1582
Interoperability endpoints
- kelli.gillott@direct.adagiohealth.nextgenshare.com
Organizations & group practices 5
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.
-
- Non-Surgical Family Planning Clinic/Center
- Aliquippa, PA
- NPI 1295826022
Nurse Practitioner
-
- Non-Surgical Family Planning Clinic/Center
- Pittsburgh, PA
- NPI 1487877023
-
- Non-Surgical Family Planning Clinic/Center
- Sharon, PA
- NPI 1609219161
-
- Non-Surgical Family Planning Clinic/Center
- Uniontown, PA
- NPI 1558455675
Nurse Practitioner
-
dba Windber Medical Center
- General Acute Care Hospital
- Windber, PA
- NPI 1275620536
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Uniontown Hospital Pharmacy
- Institutional Pharmacy
- Uniontown, PA
- NPI 1801910989
Hospital
-
- General Acute Care Hospital
- Uniontown, PA
- NPI 1861409773
-
- General Acute Care Hospital
- Uniontown, PA
- NPI 1871594127
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432684800000",
"number": "1346200375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 MILL STREET",
"city": "UNIONTOWN",
"state": "PA",
"postal_code": "15401",
"telephone_number": "724-437-1582",
"fax_number": "724-437-8328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 MILL STREET",
"city": "UNIONTOWN",
"state": "PA",
"postal_code": "15401",
"telephone_number": "724-437-1582",
"fax_number": "724-437-1571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLOTT",
"first_name": "KELLI",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "MSN CRNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-03-24",
"last_updated": "2015-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "PA",
"license": "RN512040L",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "PA",
"license": "SP006394B",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KELLI",
"last_name": "KOBALLA",
"middle_name": "ANN",
"prefix": "MISS",
"credential": "MSN CRNP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Uniontown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; 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.