Kelsey Elizabeth Waller, NP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

SP028236 Issued in PA

Practice address

351 W Schuylkill Rd # G-15a
Pottstown, PA 19465-7438

Phone

(610) 326-9460

NPI assigned

Sep 18, 2023

Last updated

Sep 18, 2023By the provider in NPPES

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 names 1

• Kelsey Jones Former name

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

Specialty

Nurse Practitioner

Education

Drexel University College of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health and Dental Care IncGroup PAC ID 5395804827, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: kelsey.waller.p1@direct.chdc.nextgenshare.com

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.

• Community Health and Dental Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Pottstown, PA
  • NPI 1295994341
  Medicare reassignment Care Compare group NPD
• Community Health and Dental Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Boyertown, PA
  • NPI 1548034663
  NPD

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1437937869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 W SCHUYLKILL RD STE G-15A",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194657438",
            "telephone_number": "610-326-9460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 W SCHUYLKILL RD # G-15A",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194657438",
            "telephone_number": "610-326-9460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Heritage Dr Ste 701",
            "address_purpose": "LOCATION",
            "city": "Pottstown",
            "state": "PA",
            "postal_code": "194643297",
            "country_code": "US",
            "telephone_number": "610-326-9460",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1315 Route 100",
            "address_purpose": "LOCATION",
            "city": "Barto",
            "state": "PA",
            "postal_code": "195048724",
            "country_code": "US",
            "telephone_number": "610-326-9460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLER",
        "first_name": "KELSEY",
        "middle_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "PA",
            "license": "SP028236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "JONES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wal-Mart Stores East, LP. (Walmart pharmacy 10-3164)
• Latonya Walker
• Shelby Jae Walker, PA-C
• Ashley Wallace
• Isabel Louise Wallace
• Charlyce J Wallington, M.D.
• Erin Elizabeth Walters, BS, MPT, DPT
• Jeffrey Michael Walters, PSY.D.
• Kathryn T. Walters, MS
• Tori Nicole Walton

• Women's Health Nurse Practitioner in Pottstown, PA
• Providers in Pottstown, PA by specialty
• Women's Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.