Individual provider Active NPI

Kelli McBride, FNP-C

  • Family Nurse Practitioner
  • Oceanside, CA
National Provider Identifier
1508373390
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95014569 Issued in CA
Practice address
200 Mercy Circle
Oceanside, CA 92055-5191
Phone
(760) 763-0306
NPI assigned
Jan 3, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 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 95014569 CA Primary

Addresses

Primary practice location

200 Mercy Circle
Oceanside, CA 92055-5191

Mailing address

200 Mercy Circle
Oceanside, CA 92055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20260323000820 CA Practitioner - Nurse Practitioner 0749541225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hoag ClinicGroup PAC ID 3274872064, 447 clinicians

Practice addresses (Care Compare)

19582 Beach Blvd
Suite 250
Huntington Beach, CA 92648-5977
Phone (714) 477-8020

Hospital & facility affiliations

  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95014569CAMDFamily 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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1508373390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MERCY CIRCLE",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "92055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MERCY CIRCLE",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920555191",
            "telephone_number": "760-763-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBRIDE",
        "first_name": "KELLI",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-03",
        "last_updated": "2023-09-18",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95014569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.