Active NPI
Kellsey Cormier, AGPCNP-BC
- Gerontology Nurse Practitioner
- Warwick, RI
National Provider Identifier
1477035749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- APRN01900
- Practice address
- 475 Kilvert St
Warwick, RI 02886-1379 - Phone
- (401) 737-6900
- NPI assigned
- Sep 4, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | APRN01900 | RI | Primary |
Addresses
Primary practice location
475 Kilvert St
Warwick, RI 02886-1379
Mailing address
9 Butterworth Dr
Somerset, MA 02726-4745
Phone (339) 788-7590
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190624001408 | RI | Order and Referring Only - Nurse Practitioner | 1052645132 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536019200000",
"number": "1477035749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 BUTTERWORTH DR",
"city": "SOMERSET",
"state": "MA",
"postal_code": "027264745",
"telephone_number": "339-788-7590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 KILVERT ST",
"city": "WARWICK",
"state": "RI",
"postal_code": "028861379",
"telephone_number": "401-737-6900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORMIER",
"first_name": "KELLSEY",
"credential": "AGPCNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-04",
"last_updated": "2018-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "RI",
"license": "APRN01900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warwick, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; 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.