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Individual provider Active NPI

Kelly Bragg, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Madison, ME
National Provider Identifier
1386121978
Registry record updated Jul 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN66178 Issued in ME
Practice address
8 S Main St
Madison, ME 04950-4501
Phone
(207) 696-3992
Fax
(207) 696-3974
NPI assigned
Jul 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN66178 ME Primary

Addresses

Primary practice location

8 S Main St
Madison, ME 04950-4501

Mailing address

PO Box 569
Rangeley, ME 04970-0569
Phone (207) 864-2699

Other practice location 1

25 Depot St
Kingfield, ME 04947-4208
Phone (207) 265-4555

Other practice location 2

177 N Main St
Strong, ME 04983-3005
Phone (207) 684-4010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180913000200 ME Practitioner - Nurse Practitioner 6608126602 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthreach Community Health CentersGroup PAC ID 5496726523, 87 clinicians

Practice addresses (Care Compare)

177 N Main St
Strong, ME 04983-3005
Phone (207) 684-4010

25 Depot St
Kingfield, ME 04947-4208
Phone (207) 265-4555

8 S Main St
Madison, ME 04950-1221
Phone (207) 696-3992

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN66178MEMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthreach Community Health Centers CurrentSince Jul 31, 2018 Accepting new patients
Healthreach Community Health Centers CurrentSince Jul 31, 2018 Accepting new patients
Healthreach Community Health Centers CurrentSince Jul 31, 2018 Accepting new patients
Healthreach Community Health Centers CurrentSince Mar 8, 2025 Accepting new patients
Healthreach Community Health Centers CurrentSince Jul 31, 2018 Accepting new patients

Locations

4 Clement Way
Belgrade, ME 04917
Phone (207) 660-9924

25 Depot St
Kingfield, ME 04947
Phone (207) 237-2658

8 S Main St
Madison, ME 04950
Phone (207) 696-3992

177 N Main St
Strong, ME 04983
Phone (207) 684-3045

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1386121978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 569",
            "city": "RANGELEY",
            "state": "ME",
            "postal_code": "049700569",
            "telephone_number": "207-864-2699",
            "fax_number": "207-864-2969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 S MAIN ST",
            "city": "MADISON",
            "state": "ME",
            "postal_code": "049504501",
            "telephone_number": "207-696-3992",
            "fax_number": "207-696-3974"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Depot St",
            "address_purpose": "LOCATION",
            "city": "Kingfield",
            "state": "ME",
            "postal_code": "049474208",
            "country_code": "US",
            "telephone_number": "207-265-4555",
            "fax_number": "207-265-5004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "177 N Main St",
            "address_purpose": "LOCATION",
            "city": "Strong",
            "state": "ME",
            "postal_code": "049833005",
            "country_code": "US",
            "telephone_number": "207-684-4010",
            "fax_number": "207-684-3368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAGG",
        "first_name": "KELLY",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "RN66178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, ME

Sources for this page

Verify at the official NPI Registry.