Individual provider Active NPI

Kristan Marie Sheffey, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Centre Hall, PA
National Provider Identifier
1487475323
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP031059 Issued in PA
Practice address
132 The Meadows Dr
Centre Hall, PA 16828-9231
Phone
(814) 364-2161
NPI assigned
Oct 23, 2024
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP031059 PA Primary

Addresses

Primary practice location

132 The Meadows Dr
Centre Hall, PA 16828-9231

Mailing address

3104 Marengo Rd
Port Matilda, PA 16870-8308
Phone (814) 470-0616

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
I20241115001526 PA Practitioner - Nurse Practitioner 6305370156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Pennsylvania Physician Alliance, LLCGroup PAC ID 8325478662, 112 clinicians

Practice addresses (Care Compare)

132 The Meadows Dr
Centre Hall, PA 16828-9231
Phone (814) 364-2161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP031059PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Pennsylvania Physician Alliance LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

132 The Meadows Dr
Centre Hall, PA 16828
Phone (814) 364-3736

2 Hospital Dr
Clarion, PA 16214
Phone (800) 253-4906

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": "1729641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1487475323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 MARENGO RD",
            "city": "PORT MATILDA",
            "state": "PA",
            "postal_code": "168708308",
            "telephone_number": "814-470-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 THE MEADOWS DR",
            "city": "CENTRE HALL",
            "state": "PA",
            "postal_code": "168289231",
            "telephone_number": "814-364-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEFFEY",
        "first_name": "KRISTAN",
        "middle_name": "MARIE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-23",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP031059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centre Hall, PA

Sources for this page

Verify at the official NPI Registry.