Individual provider Active NPI

Kelly M Parker, FNP-BC

  • Family Nurse Practitioner
  • Sparta, NJ
National Provider Identifier
1780267153
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ15495400 Issued in NJ
Practice address
89 Sparta Ave Ste 200
Sparta, NJ 07871-1790
Phone
(973) 726-7220
NPI assigned
May 3, 2021
Last updated
Mar 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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 26NJ15495400 NJ Primary

Addresses

Primary practice location

89 Sparta Ave Ste 200
Sparta, NJ 07871-1790

Mailing address

6 Pleasant Village Dr
Succasunna, NJ 07876-1144
Phone (862) 812-6412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210525002239 CT Practitioner - Nurse Practitioner 0941609994 Reassigns benefits to 6 organizations
I20260321000202 NJ Practitioner - Nurse Practitioner 0941609994 Reassigns benefits to 1 organization

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
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Merit-based Incentive Payment System (MIPS)

Final score
77.63 of 100Reported as group
Quality
62.23
Improvement activities
40
Cost
81.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ15495400NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Afc Physicians of Connecticut, PC CurrentSince Jul 7, 2024 Accepting new patients
QMG4, LLC CurrentSince Sep 7, 2021 Accepting new patients
QMG3, LLC CurrentSince Sep 7, 2021 Accepting new patients
Afc Physicians of Connecticut, PC CurrentSince Jul 7, 2024 Accepting new patients
QMG5,LLC CurrentSince Sep 7, 2021 Accepting new patients
QMG2,LLC CurrentSince Sep 7, 2021 Accepting new patients
Quentin Medical Group, LLC CurrentSince Sep 7, 2021 Accepting new patients
Bridgeport Family Medicine LLC CurrentSince May 3, 2021 Accepting new patients
Afc Physicians of Connecticut, PC CurrentSince Jul 7, 2024 Accepting new patients
Yakima Neighborhood Health Services PastSince Jul 7, 2024 Accepting new patients
QMG7,LLC PastSince Sep 7, 2021 Accepting new patients

Locations

161 Boston Ave
Bridgeport, CT 06610
Phone (203) 333-4400

4200 Main St
Bridgeport, CT 06606
Phone (203) 916-5151

754 Clinton Ave
Bridgeport, CT 06604
Phone (203) 243-6018

2 Main St
Danbury, CT 06810
Phone (203) 826-2140

74 Newtown Rd
Danbury, CT 06810
Phone (203) 826-8434

1918 Black Rock Tpke
Fairfield, CT 06825
Phone (203) 583-8400

389 Bridgeport Ave
Shelton, CT 06484
Phone (203) 567-4171

57 Monroe Tpke
Trumbull, CT 06611
Phone (203) 675-1345

Organizations & group practices 12

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": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1780267153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 PLEASANT VILLAGE DR",
            "city": "SUCCASUNNA",
            "state": "NJ",
            "postal_code": "078761144",
            "telephone_number": "862-812-6412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 SPARTA AVE STE 200",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078711790",
            "telephone_number": "973-726-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-03",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ15495400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparta, NJ

Sources for this page

Verify at the official NPI Registry.