Krystle Kelly, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

246966 Issued in NC

Practice address

3803 N Elm St
Greensboro, NC 27455-2593

Phone

(336) 941-1123

Fax

(844) 237-5916

NPI assigned

Mar 28, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1585353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1861020612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 N ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552593",
            "telephone_number": "336-941-1123",
            "fax_number": "844-237-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3803 N ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552593",
            "telephone_number": "336-941-1123",
            "fax_number": "844-237-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KRYSTLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-28",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "246966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Alan Kellogg, D.D.S.
• Andrew Wayne Kelly, DDS
• Chenay A Kelly
• Elizabeth Kelly
• Hailey Seaver Kelly, PHARMD
• Melissa D Kelly, CPNP
• Myra D Kelly, CRNA
• Shenika Kelly
• Taylor Alexandra Kelly, PA-C
• Thomas Andrew Kelly, M.D. FACC

• Family Nurse Practitioner in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.