Individual provider Active NPI

Kelly Robin Durante, CRNP

  • Family Nurse Practitioner
  • Collegeville, PA
National Provider Identifier
1376086348
Registry record updated May 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP017277 Issued in PA
Practice address
433 Komen CT.
Collegeville, PA 19426
Phone
(267) 980-3891
NPI assigned
Nov 23, 2016
Last updated
May 31, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP017277 PA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

433 Komen CT.
Collegeville, PA 19426

Mailing address

433 Komen CT.
Collegeville, PA 19426

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
I20171026003354 PA Practitioner - Nurse Practitioner 4486921517 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Seasons Medical Group of Pennsylvania, P.C. CurrentSince Jul 20, 2019 Accepting new patients
Seasons Hospice & Palliative Care of Pennsylvania, LLC Past Accepting new patients

Locations

2200 Renaissance Blvd
Ste 110
King of Prussia, PA 19406
Phone (610) 382-1800

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

NPI Registry JSON

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

{
    "created_epoch": "1479859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496188800000",
    "number": "1376086348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 KOMEN CT.",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "19426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 KOMEN CT.",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "19426",
            "telephone_number": "267-980-3891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURANTE",
        "first_name": "KELLY",
        "middle_name": "ROBIN",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-23",
        "last_updated": "2017-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017277",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collegeville, PA

Sources for this page

Verify at the official NPI Registry.