Individual provider Active NPI

Keley Brennan

  • Nurse Practitioner
  • Mooresville, NC
National Provider Identifier
1386480192
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5020475 Issued in NC
Practice address
417 E Statesville Ave
Mooresville, NC 28115-2590
Phone
(704) 663-3063
NPI assigned
Jul 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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 5020475 NC Primary

Addresses

Primary practice location

417 E Statesville Ave
Mooresville, NC 28115-2590

Mailing address

417 E Statesville Ave
Mooresville, NC 28115-2590
Phone (704) 663-3063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240928000397 NC Practitioner - Nurse Practitioner 4981135183 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacs, PCGroup PAC ID 6002121530, 10 clinicians
Duke Health Integrated Practice IncGroup PAC ID 8325412737, shared by 15 NPIs, 3,140 clinicians
Physicians Eldercare PAGroup PAC ID 0648184705, 236 clinicians
Curana Health of North Carolina PLLCGroup PAC ID 1850774332, 274 clinicians

Practice addresses (Care Compare)

10021 Park Cedar Dr
Suite 200
Charlotte, NC 28210-8701
Phone (704) 438-9383

417 E Statesville Ave
Mooresville, NC 28115-2590
Phone (704) 663-3063

5306 NC Hwy 55
Suite 105
Durham, NC 27713-7812
Phone (337) 991-9276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
500475NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Curana Health of North Carolina PLLC CurrentSince Nov 10, 2025 Accepting new patients
Physicians Eldercare PA CurrentSince Nov 10, 2025 Accepting new patients
Pacs, PC CurrentSince Sep 1, 2024 Accepting new patients

Locations

10021 Park Cedar Dr
Ste 200
Charlotte, NC 28210
Phone (704) 438-9383

5306 NC Highway 55
Ste 105
Durham, NC 27713
Phone (919) 457-1517

4692 Brownsboro Rd
Winston Salem, NC 27106
Phone (336) 251-1114

Interoperability endpoints

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

Organizations & group practices 3

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": "1719878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1386480192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 E STATESVILLE AVE",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281152590",
            "telephone_number": "704-663-3063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 E STATESVILLE AVE",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281152590",
            "telephone_number": "704-663-3063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "KELEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-02",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5020475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.