Kelly A Siegel, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP-04339 Issued in OH

Practice address

9485 Mentor Ave
Mentor, OH 44060-1716

Phone

(440) 255-5571

NPI assigned

Jul 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ksiegel28112@ehrdirect.uhhospitals.org

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.

• Lake Hospital System Inc

  • Family Medicine Physician
  • Middlefield, OH
  • NPI 1952339996

  Nurse Practitioner

  Medicare reassignment NPD
• Lake Hospital System Inc

  • Internal Medicine Physician
  • Willoughby, OH
  • NPI 1417991332
  NPD

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1427075415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9485 MENTOR AVE SUITE 210",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "44060",
            "telephone_number": "440-255-5571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9485 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440601716",
            "telephone_number": "440-255-5571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7590 Auburn Rd.",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "OH",
            "postal_code": "44077",
            "country_code": "US",
            "telephone_number": "440-255-5571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36000 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Willoughby",
            "state": "OH",
            "postal_code": "44095",
            "country_code": "US",
            "telephone_number": "440-255-5571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "KELLY",
        "middle_name": "A",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "NP-04339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2160683",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "000000224469",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000539712",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE",
            "identifier": "740018",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE",
            "identifier": "746018",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "364120",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7240712",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelly.siegel@lhpg.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Baseline West Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "9485 Mentor Avenue",
            "address_2": "Suite 210",
            "city": "Mentor",
            "state": "OH",
            "country_code": "US",
            "postal_code": "44060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rob Shulman, R.PH.
• Deanna Shumate, RN
• Sondra Akins Siatkowski, AGNP-C
• Heather Sibley, LSW
• Virginia Sidlo, LISW
• Kailey Elizabeth Sikora
• Daniel Ryan Silbiger, D.O.
• Jennifer Lynn Simmons
• Kaitlynn Simms
• Heather Marie Simon

• Nurse Practitioner in Mentor, OH
• Providers in Mentor, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.