Kristy Payne
Individual provider Active NPI Family Nurse Practitioner · MC Connellsburg, PA
NPI 1831603810 · NPPES record last updated Mar 23, 2018
Key facts
- NPI
- 1831603810
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- SP018112 (PA)
- Practice address
- 525 Fulton Dr
MC Connellsburg, PA 17233-8061 - Phone
- (717) 485-3850
- NPI assigned
- Nov 28, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tri-State Community Health Center Inc
Practice addresses (Care Compare)
214 Peach Orchard Rd
MC Connellsburg, PA 17233-8559
Phone (717) 485-3155
525 Fulton Dr
MC Connellsburg, PA 17233-8061
Phone (717) 485-3850
Hospital & facility affiliations
- Fulton County Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180514000106 | PA | Practitioner - Nurse Practitioner | 8729342035 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP018112 | PA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri-State Community Health Center, Inc | Current |
Accepting new patients | |
| Tri-State Community Health Center, Inc | Current |
Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
109 Rayloc Dr
Hancock, MD 21750
Phone (301) 678-5187
525 Fulton Dr
Mc Connellsburg, PA 17233
Phone (717) 485-3850
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | SP018112 | PA | Yes |
Addresses
Primary practice location
525 Fulton Dr
MC Connellsburg, PA 17233-8061
Mailing address
109 Rayloc Dr
Hancock, MD 21750-1518
Phone (301) 678-5187
Other providers in MC Connellsburg, PA
- NHS Stevens Center
- NHS Stevens Center
- Kelli Renee Oswald
- Paul B Macdonald'S Pharmacy Inc
- Paul B Macdonald'S Pharmacy Inc
- Matthew D. Pilkerton
- Dustin Pine
- Erin Jenine Pistner
- Colleen Marie Powers
- Emily Nicole Ramsey
All providers in MC Connellsburg, PA · Family Nurse Practitioner in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.