Individual provider Active NPI

Kellie Shapiro, CRNP

  • Nurse Practitioner
  • Lemoyne, PA
National Provider Identifier
1477028199
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP019387 Issued in PA
Practice address
50 N 12TH St
Lemoyne, PA 17043-1440
Phone
(717) 234-2561
Fax
(717) 236-1121
NPI assigned
Oct 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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 SP019387 PA Primary

Addresses

Primary practice location

50 N 12TH St
Lemoyne, PA 17043-1440

Mailing address

50 N 12TH St
Lemoyne, PA 17043-1440
Phone (717) 234-2561

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
I20181106001008 PA Practitioner - Nurse Practitioner 8527311711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penn State Health Medical Group LLCGroup PAC ID 8729351077, 720 clinicians

Practice addresses (Care Compare)

50 N 12TH St
Pshmg Pulmonary Crit
Lemoyne, PA 17043-1440
Phone (717) 234-2561

Hospital & facility affiliations

  • Penn State Health Holy Spirit Medical Center Hospital, Camp Hill, PA, CCN 390004

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
65.84
Promoting interoperability
100
Improvement activities
40
Cost
77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP019387PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Penn State Health Medical Group, LLC CurrentSince Mar 1, 2020 Accepting new patients
Penn State Health Medical Group, LLC Current Accepting new patients
Penn State Health Medical Group, LLC Past Accepting new patients

Locations

220 Wilson St
Ste 104
Carlisle, PA 17013
Phone (717) 218-1832

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

50 N 12th St
Lemoyne, PA 17043
Phone (717) 243-2561

1819 S Market St
#A
Mechanicsburg, PA 17055
Phone (717) 620-2020

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1477028199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N 12TH ST",
            "city": "LEMOYNE",
            "state": "PA",
            "postal_code": "170431440",
            "telephone_number": "717-234-2561",
            "fax_number": "717-236-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N 12TH ST",
            "city": "LEMOYNE",
            "state": "PA",
            "postal_code": "170431440",
            "telephone_number": "717-234-2561",
            "fax_number": "717-236-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "KELLIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP019387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemoyne, PA

Sources for this page

Verify at the official NPI Registry.