Individual provider Active NPI

Kelly Lorriane Smith, FNP-BC

  • Primary Care Nurse Practitioner
  • Cary, NC
National Provider Identifier
1831860428
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
5015055 Issued in NC
Practice address
251 Keisler Dr Ste 201
Cary, NC 27518-7091
Phone
(919) 322-5440
NPI assigned
Sep 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X 5015055 NC Primary

Addresses

Primary practice location

251 Keisler Dr Ste 201
Cary, NC 27518-7091

Mailing address

417 W Peace St Apt 311
Raleigh, NC 27603-5021
Phone (832) 588-6328

Other identifiers 1

IdentifierTypeStateIssuer
5015055OtherNCNC BON

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5015055NCMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1831860428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 W PEACE ST APT 311",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276035021",
            "telephone_number": "832-588-6328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 KEISLER DR STE 201",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187091",
            "telephone_number": "919-322-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KELLY",
        "middle_name": "LORRIANE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-23",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "5015055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BON",
            "identifier": "5015055",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.