Lisa M Gondek Kelly, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

525 Issued in SC

Practice address

7 Independence PT Ste 300
Greenville, SC 29615-4569

Phone

(864) 522-3700

Fax

(864) 522-3705

NPI assigned

Nov 29, 2005

Last updated

Jan 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Lisa M Kelly Professional name

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

University of Wisconsin School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prisma Health Oconee Memorial Hospital Hospital, Seneca, SC, CCN 420009

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

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.

• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217
  Medicare reassignment Care Compare group NPD
• Greenville Health System

  dba GHS Patewood Memorial Hospital

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1568532513
  Medicare reassignment NPD
• Prisma Health-Upstate

  dba Prisma Health Greenville Memorial Hospital

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1649726738
  Medicare reassignment NPD
• Greenville Health System

  dba Greenville Health System EMS - Oconee Memorial

  • General Acute Care Hospital
  • Seneca, SC
  • NPI 1164821831
  NPD
• Greenville Health System

  dba GHS Cardiovascular SVCS Simp

  • General Acute Care Hospital
  • Simpsonville, SC
  • NPI 1679992838
  NPD
• Pathology Associates of Greenville PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Greenville, SC
  • NPI 1831151976
  NPD
• Prisma Health University Medical Group

  dba Parkside OB-GYN

  • Gynecology Physician
  • Greer, SC
  • NPI 1003619313
  NPD
• Prisma Health University Medical Group

  dba GHS Pih Dba Umg GVL Anesthes

  • Anesthesiology Physician
  • Greenville, SC
  • NPI 1528465374
  NPD
• Prisma Health-Upstate

  dba Prisma Health Oconee Memorial Hospital

  • General Acute Care Hospital
  • Seneca, SC
  • NPI 1063968196
  NPD
• Prisma Health-Upstate

  dba Prisma Health Wonder Center-Non Medicaid

  • Medically Fragile Infants and Children Day Care
  • Greenville, SC
  • NPI 1811439649
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prisma Health-Upstate

  dba Prisma Health Oconee Memorial Hospital

  • General Acute Care Hospital
  • Seneca, SC
  • NPI 1063968196
  Care Compare affiliation
• Prisma Health-Upstate

  dba Prisma Health Center For Family Medicine-Oconee

  • Clinic/Center
  • Seneca, SC
  • NPI 1407345846

  Hospital

  Care Compare affiliation
• Prisma Health-Upstate

  dba Prisma Health Oconee Pain Management

  • Pain Clinic/Center
  • Seneca, SC
  • NPI 1891237632

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1720061203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE",
            "address_2": "FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 INDEPENDENCE PT STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154569",
            "telephone_number": "864-522-3700",
            "fax_number": "864-522-3705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "298 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Seneca",
            "state": "SC",
            "postal_code": "296729443",
            "country_code": "US",
            "telephone_number": "864-882-3351",
            "fax_number": "864-885-7619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONDEK KELLY",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID - GROUP",
            "identifier": "400097",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - GROUP",
            "identifier": "1152",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN0929",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2991",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "KELLY",
            "middle_name": "M",
            "credential": "CRNA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Anna A Goldston, DMD
• Al R Golec, R.PH.
• Judith Gomes
• Dinorah Marie Gomez, MD
• Todd Stephen Gomez, LCSW,LISW
• Jessica Gonzalez Hernandez, MD
• Adam Gonzalez, MD
• Elena Gonzalez
• Jeanne Cameron Gonzalez, ARNP, APRN
• Jessica Shuffler Gonzalez, DO

• Certified Registered Nurse Anesthetist in Greenville, SC
• Providers in Greenville, SC by specialty
• Certified Registered Nurse Anesthetist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.