Individual provider Active NPI

Kelli Bates Payne, CRNP

  • Nurse Practitioner
  • Auburn, AL
National Provider Identifier
1366046195
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-159787 Issued in AL
Practice address
2375 Champions Blvd Ste 102
Auburn, AL 36830-6471
Phone
(334) 528-6320
NPI assigned
Nov 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-159787 AL Primary

Addresses

Primary practice location

2375 Champions Blvd Ste 102
Auburn, AL 36830-6471

Mailing address

2375 Champions Blvd Ste 102
Auburn, AL 36830-6471
Phone (334) 528-6320

Other names 1

  • Kelli Bates Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20210131000014 AL Practitioner - Nurse Practitioner 8628482858 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

Practice addresses (Care Compare)

2375 Champions Blvd
Suite 102
Auburn, AL 36830-6471
Phone (334) 203-1917

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.26 of 100Reported as group
Quality
78.94
Promoting interoperability
100
Improvement activities
40
Cost
72.7

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-159787ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The East Alabama Health Care Authority CurrentSince Aug 1, 2022 Accepting new patients
The East Alabama Health Care Authority CurrentSince Aug 1, 2022 Accepting new patients

Locations

2375 Champions Blvd
Ste 102
Auburn, AL 36830
Phone (334) 528-6320

2570 Village Professional Dr
Opelika, AL 36801
Phone (334) 203-1917

2000 Pepperell Pkwy
Opelika, AL 36801
Phone (334) 364-3300

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.181001
  • FHIR API: https://fhir-myrecord.cerner.com/r4/c5013bf3-ebba-4bda-8574-ed83da9e1633/

Organizations & group practices 2

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 1

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": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1366046195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2375 CHAMPIONS BLVD STE 102",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368306471",
            "telephone_number": "334-528-6320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 CHAMPIONS BLVD STE 102",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368306471",
            "telephone_number": "334-528-6320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "KELLI",
        "middle_name": "BATES",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-23",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-159787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "BATES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Auburn, AL

Sources for this page

Verify at the official NPI Registry.