Individual provider Active NPI

Kellie Lynn Forshey, FNP

  • Family Nurse Practitioner
  • Kingston, NY
National Provider Identifier
1750052643
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
347992 Issued in NY
Practice address
334 Plaza Rd
Kingston, NY 12401-2975
Phone
(845) 338-0180
NPI assigned
Sep 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 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 347992 NY Primary

Addresses

Primary practice location

334 Plaza Rd
Kingston, NY 12401-2975

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Other practice location 1

315 S Manning Blvd
Albany, NY 12208-1707
Phone (518) 525-1563

Other names 1

  • Kellie Stevens Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220218001928 NY Practitioner - Nurse Practitioner 5698169555 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
347992NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter's Health Partners Medical Associates, P.C. CurrentSince Jun 11, 2023 Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

Interoperability endpoints

  • Direct secure messaging: kforshey2745418@direct.trinity-health.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1750052643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 PLAZA RD",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124012975",
            "telephone_number": "845-338-0180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 S Manning Blvd",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122081707",
            "country_code": "US",
            "telephone_number": "518-525-1563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORSHEY",
        "first_name": "KELLIE",
        "middle_name": "LYNN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-22",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "347992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP - Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "315 S Manning Blvd",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "STEVENS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.