Kelly D Crim, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

214884 Issued in LA

Practice address

4809 Ambassador Caffery Pkwy Ste 410
Lafayette, LA 70508-8802

Phone

(337) 470-4881

Fax

(337) 470-4882

NPI assigned

Dec 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 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA

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

University of Alabama School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lourdes Physician Group LLCGroup PAC ID 7214177757, 157 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Our Lady of Lourdes Regional Medical Center, Inc Hospital, Lafayette, LA, CCN 190102

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kcrim3395365@direct.casso.us.com

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.

• Lourdes Physician Group LLC

  • Family Medicine Physician
  • Lafayette, LA
  • NPI 1437405883

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• St. Tammany Parish Hospital Service District No 1

  • Family Medicine Physician
  • Folsom, LA
  • NPI 1275539363
  Medicare reassignment NPD
• St. Tammany Parish Hospital Service District No 1

  • General Acute Care Hospital
  • Covington, LA
  • NPI 1598798597
  Medicare reassignment NPD
• St Tammany Parish Hospital Service District No 1

  • Internal Medicine Physician
  • Covington, LA
  • NPI 1083793582
  NPD
• St. Tammany Parish Hospital Service District No 1

  • Orthopaedic Surgery Physician
  • Covington, LA
  • NPI 1598193625
  NPD

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

• Our Lady of Lourdes Regional Medical Center, Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1598766495
  Care Compare affiliation

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

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1841838125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "337-470-4881",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4809 AMBASSADOR CAFFERY PKWY STE 410",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705088802",
            "telephone_number": "337-470-4881",
            "fax_number": "337-470-4882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "971 Lakeland Dr Ste 1460",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164684",
            "country_code": "US",
            "telephone_number": "601-982-3202",
            "fax_number": "601-982-3259",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1202 S Tyler St",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "LA",
            "postal_code": "704332330",
            "country_code": "US",
            "telephone_number": "985-898-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRIM",
        "first_name": "KELLY",
        "middle_name": "D",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-17",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "214884",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "903261",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "214884",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LAKELAND SURGICAL CLINIC, PLLC",
            "identifier": "640604703",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Leigh Credeur, APRN
• Sally S. Creed, LPC
• Gwyn Acosta Creek
• CRG Clinical Services LLC
• Jessica M Criddle
• William Lee Crim III, DO
• Robert Louis Crist Jr.
• Critical Care Newborn Services
• Bridget Landry Crochet, LCSW
• Ella C Crochet

• Nurse Practitioner in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.