Individual provider Active NPI

Kelly Marie Schultz, MSN FNP-C

  • Family Nurse Practitioner
  • Crown Point, IN
National Provider Identifier
1558956755
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
710711025A Issued in IN
Practice address
2272 N Main St
Crown Point, IN 46307-1802
Phone
(219) 661-5601
NPI assigned
Mar 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F02211054 IN
Family Nurse Practitioner 363LF0000X 710711025A IN Primary

Addresses

Primary practice location

2272 N Main St
Crown Point, IN 46307-1802

Mailing address

2272 N Main St
Crown Point, IN 46307-1802
Phone (219) 661-5601

Other practice location 1

303 N 7th St
Kentland, IN 47951-1379
Phone (219) 474-5464

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kelly.schultz.1@15486.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20210330001886 IN Practitioner - Nurse Practitioner 8921415449 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.88 of 100Reported as group
Quality
79.78
Improvement activities
40
Cost
80.01

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
710711025AINMDFamily Nurse Practitioner
F02211054INMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aims, LLC CurrentSince Mar 1, 2021 Accepting new patients
Theoria Medical CurrentSince Dec 15, 2024 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

155 E Burks Dr
Bloomington, IN 47401
Phone (812) 322-4437

417 S Whitlock St
Bremen, IN 46506
Phone (574) 546-0330

9330 Broadway
Crown Point, IN 46307
Phone (219) 648-2400

6720 Parkdale Pl
Indianapolis, IN 46254
Phone (219) 648-2400

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

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.

NPI Registry JSON

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

{
    "created_epoch": "1615248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1558956755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2272 N MAIN ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071802",
            "telephone_number": "219-661-5601",
            "fax_number": "574-485-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2272 N MAIN ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071802",
            "telephone_number": "219-661-5601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 N 7th St",
            "address_purpose": "LOCATION",
            "city": "Kentland",
            "state": "IN",
            "postal_code": "479511379",
            "country_code": "US",
            "telephone_number": "219-474-5464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSN FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-09",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "F02211054",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "710711025A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelly.schultz.1@15486.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "303 N 7th St",
            "city": "Kentland",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479511379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.