Kiley Elizabeth Fair, AGACNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

APRN02024 Issued in RI

Practice address

593 Eddy St
Providence, RI 02903-4923

Phone

(401) 444-3565

Fax

(401) 444-5493

NPI assigned

Oct 17, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Affinity Physicians LLC.Group PAC ID 0244413391, 723 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kent County Memorial Hospital Hospital, Warwick, RI, CCN 410009

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Affinity Physicians LLC.

  • Internal Medicine Physician
  • Warwick, RI
  • NPI 1184944662
  Medicare reassignment Care Compare group NPD
• Brown Medicine

  • Internal Medicine Physician
  • Riverside, RI
  • NPI 1689626764

  Nurse Practitioner

  Medicare reassignment NPD
• Lifespan Physician Group, Inc.

  • General Practice Physician
  • Providence, RI
  • NPI 1407116643
  Medicare reassignment
• Affinity Physicians LLC

  • Anesthesiology Physician
  • Providence, RI
  • NPI 1053038471
  NPD
• Brown Medicine

  • Internal Medicine Physician
  • Riverside, RI
  • NPI 1437897469

  Nurse Practitioner

  NPD
• Brown Medicine

  • Gastroenterology Physician
  • Providence, RI
  • NPI 1730827767

  Nurse Practitioner

  NPD
• Lifespan Physician Group, Inc.

  • General Practice Physician
  • Riverside, RI
  • NPI 1215899869
  NPD
• Lifespan Physician Group, Inc.

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678

  Nurse Practitioner

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kent County Memorial Hospital

  • Rehabilitation Hospital Unit
  • Warwick, RI
  • NPI 1023017944
  Care Compare affiliation
• Kent County Memorial Hospital

  • General Acute Care Hospital
  • Warwick, RI
  • NPI 1386643294
  Care Compare affiliation

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1841832235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 ELM ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034626",
            "telephone_number": "401-443-4992",
            "fax_number": "401-537-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-3565",
            "fax_number": "401-444-5493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 Toll Gate Rd",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028862759",
            "country_code": "US",
            "telephone_number": "401-737-7000 x35132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAIR",
        "first_name": "KILEY",
        "middle_name": "ELIZABETH",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-17",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN02024",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "RI",
            "license": "APRN02024",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "RI",
            "license": "APRN02024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark J Fagan, MD
• Cynthia Ann Fahey, PAC
• Sydney Elizabeth Fahey, MA
• Faith Fahnbulleh
• Momoh Bai Fahnbulleh
• Alexander M Fairhurst, PHARMD
• Khawaja Hasham Faisal, MD
• Mohammed Faizan, M.D.
• Laurel Falces, NP
• Nabil Sean Falconer, PT, DPT

• Gerontology Nurse Practitioner in Providence, RI
• Providers in Providence, RI by specialty
• Gerontology Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.

Verify at the official NPI Registry.