Active NPI
Erin Elizabeth Kelly, NP
- Nurse Practitioner
- Clemmons, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5006073
- Practice address
- 6915 Village Medical Cir
Clemmons, NC 27012-8002 - Phone
- (336) 893-1527
- Fax
- (336) 893-1596
- NPI assigned
- Dec 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 5006073 | NC | |
| Nurse Practitioner | 363L00000X | 5006073 | NC | Primary |
Addresses
Primary practice location
6915 Village Medical Cir
Clemmons, NC 27012-8002
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Other practice location 1
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-4131
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6915 Village Medical Cir
Clemmons, NC 27012-8002
Phone (704) 384-7606
Hospital & facility affiliations
- Novant Health Forsyth Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5006073 | NC | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Past | Accepting new patients |
Locations
6915 Village Medical Cir
Clemmons, NC 27012
Phone (336) 718-1680
1750 Kernersville Medical Pkwy
Kernersville, NC 27284
Phone (336) 564-4000
5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441
2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300
Interoperability endpoints
- ekelly1048064@direct.novanthealth.org
Organizations & group practices 4
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.
-
- Neurology with Special Qualifications in Child Neurology Physician
- Charlotte, NC
- NPI 1366409492
-
- Obstetrics & Gynecology Physician
- Matthews, NC
- NPI 1386506137
-
- Internal Medicine Physician
- Clemmons, NC
- NPI 1992152078
-
- Internal Medicine Physician
- Charlotte, NC
- NPI 1134841802
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Winston Salem, NC
- NPI 1447200233
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654128000000",
"number": "1801964697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60447",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282600447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6915 VILLAGE MEDICAL CIR",
"city": "CLEMMONS",
"state": "NC",
"postal_code": "270128002",
"telephone_number": "336-893-1527",
"fax_number": "336-893-1596"
}
],
"practiceLocations": [
{
"address_1": "Medical Center Blvd",
"address_purpose": "LOCATION",
"city": "Winston Salem",
"state": "NC",
"postal_code": "271570001",
"country_code": "US",
"telephone_number": "336-716-4131",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KELLY",
"first_name": "ERIN",
"middle_name": "ELIZABETH",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2022-06-02",
"certification_date": "2022-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NC",
"license": "5006073",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "5006073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clemmons, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; 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.