Individual provider Active NPI

Christopher Raymond Kebberly, CRNP

  • Family Nurse Practitioner
  • Johnstown, PA
National Provider Identifier
1578192969
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP021815 Issued in PA
Practice address
1322 Eisenhower Blvd
Johnstown, PA 15904-3307
Phone
(814) 266-8840
Fax
(814) 266-2176
NPI assigned
Apr 7, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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 SP021815 PA Primary

Addresses

Primary practice location

1322 Eisenhower Blvd
Johnstown, PA 15904-3307

Mailing address

1322 Eisenhower Blvd
Johnstown, PA 15904-3307
Phone (814) 266-8840

Other practice location 1

939 Menoher Blvd
Johnstown, PA 15905-2830
Phone (814) 262-9500

Other practice location 2

126 E Church St
Somerset, PA 15501-2271
Phone (814) 443-1789

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
I20221104001394 SC Practitioner - Nurse Practitioner 9537578323 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

2435 Forest Dr
Columbia, SC 29204-2026
Phone (803) 256-5300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
64.93
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
86.99 of 100Reported as group
Quality
81.65
Improvement activities
40
Cost
74.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26527SCMDSports Medicine (Neuromusculoskeletal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group South Carolina CurrentSince Oct 1, 2022 Accepting new patients
Musc Community Physicians CurrentSince Nov 1, 2023 Accepting new patients
Apogee Medical Group of Pennsylvania PC CurrentSince May 1, 2021 Accepting new patients
Musc Community Physicians CurrentSince Nov 1, 2023 Accepting new patients
Apogee Medical Group of Pennsylvania PC CurrentSince May 1, 2021 Accepting new patients
Musc Community Physicians Current Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Past Accepting new patients

Locations

15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

1315 Roberts St
Camden, SC 29020
Phone (803) 432-4311

2435 Forest Dr
Columbia, SC 29204
Phone (770) 874-6859

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 and National Provider Directory roles.

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": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1578192969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 EISENHOWER BLVD",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043307",
            "telephone_number": "814-266-8840",
            "fax_number": "814-266-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 EISENHOWER BLVD",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043307",
            "telephone_number": "814-266-8840",
            "fax_number": "814-266-2176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "939 Menoher Blvd",
            "address_purpose": "LOCATION",
            "city": "Johnstown",
            "state": "PA",
            "postal_code": "159052830",
            "country_code": "US",
            "telephone_number": "814-262-9500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "126 E Church St",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "PA",
            "postal_code": "155012271",
            "country_code": "US",
            "telephone_number": "814-443-1789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEBBERLY",
        "first_name": "CHRISTOPHER",
        "middle_name": "RAYMOND",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-07",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP021815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.