NPIMap

Individual provider Active NPI

Kelly Vial, FNP

  • Nurse Practitioner
  • South Lake Tahoe, CA
National Provider Identifier
1447486295
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
18964 Issued in CA
Practice address
1090 3Rd St
South Lake Tahoe, CA 96150-3485
Phone
(530) 543-5660
Fax
(530) 542-1619
NPI assigned
Jun 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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 18964 CA Primary

Addresses

Primary practice location

1090 3Rd St
South Lake Tahoe, CA 96150-3485

Mailing address

1111 Emerald Bay Rd
South Lake Tahoe, CA 96150-6207
Phone (530) 543-5659

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20090910000161 CA Practitioner - Nurse Practitioner 7012062375 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Barton Healthcare System CurrentSince Nov 1, 2017 Accepting new patients
Tahoe Carson Valley Medical Group Inc CurrentSince Jun 1, 2010 Accepting new patients
Barton Medical Foundation CurrentSince Jan 1, 2023 Accepting new patients
Barton Healthcare System Past Accepting new patients

Locations

2201 South Ave
South Lake Tahoe, CA 96150
Phone (530) 543-5550

1111 Emerald Bay Rd
South Lake Tahoe, CA 96150
Phone (530) 543-5659

2175 South Ave
South Lake Tahoe, CA 96150
Phone (530) 543-5711

1139 3rd St
South Lake Tahoe, CA 96150
Phone (530) 541-3100

2074 Lake Tahoe Blvd
Ste 4
South Lake Tahoe, CA 96150
Phone (530) 543-5554

2170 South Ave
South Lake Tahoe, CA 96150
Phone (530) 541-3420

1090 3rd St
South Lake Tahoe, CA 96150
Phone (530) 543-5660

Interoperability endpoints

  • Direct secure messaging: kvial65098@direct.renown.org

Organizations & group practices 11

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barton Healthcare System 24 clinicians

Practice addresses (Care Compare)

2170 S Ave
South Lake Tahoe, CA 96150

2170 S Ave
South Lake Tahoe, CA 96150-7008

2170 S Ave
South Lake Tahoe, CA 96150-7026
Phone (530) 543-5553

3860 Saddle Rd
South Lake Tahoe, CA 96150-8673
Phone (530) 643-5553

Hospital & facility affiliations

  • Barton Healthcare System Home Health Home health agency, South Lake Tahoe, CA, CCN 057226
  • Barton Memorial Hospital Hospital, South Lake Tahoe, CA, CCN 050352
  • Carson Valley Health Hospital, Gardnerville, NV, CCN 291306
  • Carson Tahoe Regional Medical Center Hospital, Carson City, NV, CCN 290019

Merit-based Incentive Payment System (MIPS)

Final score
95.71 of 100Reported as apm
Quality
89.85
Promoting interoperability
94.05
Improvement activities
40

NPI Registry JSON

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1447486295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 EMERALD BAY RD",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506207",
            "telephone_number": "530-543-5659",
            "fax_number": "530-541-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 3RD ST",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961503485",
            "telephone_number": "530-543-5660",
            "fax_number": "530-542-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIAL",
        "first_name": "KELLY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-08",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "18964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lake Tahoe, CA

Sources for this page

Verify at the official NPI Registry.