Individual provider Active NPI

Kellie Fitzpatrick, CRNP

  • Adult Health Nurse Practitioner
  • Phila, PA
National Provider Identifier
1467321133
Registry record updated May 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP034482 Issued in PA
Practice address
12265 Townsend Rd
Phila, PA 19154-1201
Phone
(215) 671-9200
NPI assigned
Nov 1, 2025
Last updated
May 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP034482 PA Primary
Adult Health Nurse Practitioner 363LA2200X RN511318L PA

Addresses

Primary practice location

12265 Townsend Rd
Phila, PA 19154-1201

Mailing address

12265 Townsend Rd
Phila, PA 19154-1201
Phone (215) 671-9200

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260519004245 PA Practitioner - Nurse Practitioner 9335618347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1648 Huntingdon Pike
FL 1
Jenkintown, PA 19046-8078

9 Executive Campus
Cherry Hill, NJ 08002-4502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN511318LPAMDAdult Health Nurse Practitioner
SP034482PAMDAdult Health Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1761955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777680000000",
    "number": "1467321133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12265 TOWNSEND RD",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191541201",
            "telephone_number": "215-671-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12265 TOWNSEND RD",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191541201",
            "telephone_number": "215-671-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "KELLIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-01",
        "last_updated": "2026-05-02",
        "certification_date": "2026-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP034482",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "RN511318L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phila, PA

Sources for this page

Verify at the official NPI Registry.