NPIMap

Individual provider Active NPI

Elizabeth Erin Kelly, FNP

  • Family Nurse Practitioner
  • Easley, SC
National Provider Identifier
1861276792
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28045 Issued in SC
Practice address
1351 Crestview Rd
Easley, SC 29642-2408
Phone
(864) 855-5006
Fax
(864) 850-1992
NPI assigned
Aug 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2023032360 SC
Family Nurse Practitioner 363LF0000X 28045 SC Primary

Addresses

Primary practice location

1351 Crestview Rd
Easley, SC 29642-2408

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

108 Sevan Ln
Easley, SC 29642-9404
Phone (864) 915-6432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240206004494 SC Practitioner - Nurse Practitioner 6901249986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1351 Crestview Rd
Easley, SC 29642-2408
Phone (864) 855-5006

Hospital & facility affiliations

  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078
  • Prisma Health Baptist Easley Hospital Hospital, Easley, SC, CCN 420015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023032360SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Dec 4, 2023 Accepting new patients
Prisma Health University Medical Group CurrentSince Dec 4, 2023 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1351 Crestview Rd
Easley, SC 29642
Phone (864) 855-1942

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

Interoperability endpoints

  • Direct secure messaging: ekelly738770@direct.ghs.myhfn.org

Organizations & group practices 3

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.

Hospital & facility affiliations 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1861276792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 CRESTVIEW RD",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296422408",
            "telephone_number": "864-855-5006",
            "fax_number": "864-850-1992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 Sevan Ln",
            "address_purpose": "LOCATION",
            "city": "Easley",
            "state": "SC",
            "postal_code": "296429404",
            "country_code": "US",
            "telephone_number": "864-915-6432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ELIZABETH",
        "middle_name": "ERIN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "2023032360",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "28045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easley, SC

Sources for this page

Verify at the official NPI Registry.