Individual provider Active NPI

Kelli Anne Rosson, FNP

  • Family Nurse Practitioner
  • Spartanburg, SC
National Provider Identifier
1497457634
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
27202 Issued in SC
Practice address
460 Langdon St
Spartanburg, SC 29302-1614
Phone
(864) 582-2411
NPI assigned
Mar 21, 2023
Last updated
Mar 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 27202 SC Primary

Addresses

Primary practice location

460 Langdon St
Spartanburg, SC 29302-1614

Mailing address

460 Langdon St
Spartanburg, SC 29302-1614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20231201002208 SC Practitioner - Nurse Practitioner 6002264918 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regenesis Organization Community Health CenterGroup PAC ID 8022928001, shared by 9 NPIs, 35 clinicians

Practice addresses (Care Compare)

460 Langdon St
Spartanburg, SC 29302-1614
Phone (864) 504-3628

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27202SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regenesis Organization Community Health Center Current Accepting new patients
Regenesis Organization Community Health Center CurrentSince Nov 16, 2024 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Oct 17, 2023 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Oct 17, 2023 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Oct 17, 2023 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Oct 17, 2023 Accepting new patients
Regenesis Organization Community Health Center CurrentSince Oct 17, 2023 Accepting new patients

Locations

301 Crescent Ave
Spartanburg, SC 29306
Phone (864) 582-2817

460 Langdon St
Spartanburg, SC 29302
Phone (864) 582-2817

750 S Church St
Spartanburg, SC 29306
Phone (864) 582-2829

115 Thomas St
#B
Union, SC 29379

Organizations & group practices 7

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.

Hospital & facility affiliations 4

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": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1497457634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 LANGDON ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 LANGDON ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021614",
            "telephone_number": "864-582-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSON",
        "first_name": "KELLI",
        "middle_name": "ANNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "27202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.