Kelly Crenshaw

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5007819 Issued in NC

Practice address

6112 Saint Giles St
Raleigh, NC 27612-7043

Phone

(919) 893-4465

NPI assigned

Aug 6, 2015

Last updated

Dec 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Advaita Integrated Medicine PLLCGroup PAC ID 4385023043, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Advaita Integrated Medicine PLLC

  • Psychiatry Physician
  • Raleigh, NC
  • NPI 1437727088
  Medicare reassignment Care Compare group NPD
• Carolina Partners in Mental

  dba Carolina Partners of Raleigh NC

  • Non-Pharmacy Dispensing Site
  • Raleigh, NC
  • NPI 1861810715
  NPD (past)
• Green Hill Recovery, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Raleigh, NC
  • NPI 1235663790
  NPD (past)

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1790161263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6112 SAINT GILES ST STE 103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276127043",
            "telephone_number": "919-893-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6112 SAINT GILES ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276127043",
            "telephone_number": "919-893-4465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3610 Bush St",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276097511",
            "country_code": "US",
            "telephone_number": "919-876-3130",
            "fax_number": "919-876-3134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRENSHAW",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-06",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5007819",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5007819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Parker Creekmore, RPH
• Marsha Lynn Creekmore, MED.
• Sarah Creekmore, PTA
• Erin Lan Creel
• Rachel Elizabeth Rohan Creel, CRNA
• Michele Opal Crenshaw, LCSW
• Neely Parker Crenshaw, LCMHCA, NCC
• Anthony Eric Crescienzi, MSAT, ATC
• Isabel Frances Crespo
• Tonya Lynn Crespo, MSN, FNP-C, WHNP-BC

• Psychiatric/Mental Health Nurse Practitioner in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.