Individual provider Active NPI

Kelsey Renee Harris, APRN, FNP-C

  • Family Nurse Practitioner
  • Great Bend, KS
National Provider Identifier
1619503117
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-79304-101 Issued in KS
Practice address
3515 Broadway Ave
Great Bend, KS 67530-3633
Phone
(620) 792-3345
NPI assigned
Mar 16, 2020
Last updated
Jun 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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 53-79304-101 KS Primary

Addresses

Primary practice location

3515 Broadway Ave
Great Bend, KS 67530-3633

Mailing address

3515 Broadway Ave
Great Bend, KS 67530-3633
Phone (620) 792-2511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20230127002036 KS Practitioner - Nurse Practitioner 7719305689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Center, P.a.Group PAC ID 3971408642, 25 clinicians
Hutchinson Clinic PA IncGroup PAC ID 5597658492, 130 clinicians
Ukhs Great Bend LLCGroup PAC ID 5597016378, shared by 6 NPIs, 64 clinicians

Practice addresses (Care Compare)

1100 N Main St
Hutchinson, KS 67501-4406

2101 N Waldron St
Hutchinson, KS 67502-1131
Phone (620) 669-2500

3515 Broadway Ave
Great Bend, KS 67530-3633
Phone (620) 786-6515

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53-79304-101KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hutchinson Clinic, P.a., Inc. CurrentSince Jan 1, 2023 Accepting new patients
Hutchinson Clinic, P.a., Inc. Current Accepting new patients
Hutchinson Clinic, PA, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Hutchinson Clinic, P.a. Inc. Current Accepting new patients
Hutchinson Clinic, P.a., Inc. Current Accepting new patients

Locations

2101 N Waldron St
Hutchinson, KS 67502
Phone (620) 669-2500

Interoperability endpoints

  • Direct secure messaging: kelseyharris@hcpa.allscriptsdirect.net

Organizations & group practices 5

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": "1584316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1619503117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 BROADWAY AVE",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303633",
            "telephone_number": "620-792-2511",
            "fax_number": "620-786-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 BROADWAY AVE",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303633",
            "telephone_number": "620-792-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "KELSEY",
        "middle_name": "RENEE",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-16",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-79304-101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Bend, KS

Sources for this page

Verify at the official NPI Registry.