Individual provider Active NPI

Kellie Walter Furin, FNP

  • Family Nurse Practitioner
  • Carrboro, NC
National Provider Identifier
1861574303
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5002294 Issued in NC
Practice address
127 Fidelity St
Carrboro, NC 27510-2002
Phone
(919) 933-8381
Fax
(919) 933-6623
NPI assigned
Oct 20, 2006
Last updated
Jul 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5002294 NC Primary

Addresses

Primary practice location

127 Fidelity St
Carrboro, NC 27510-2002

Mailing address

127 Fidelity St
Carrboro, NC 27510-2002
Phone (919) 933-8381

Other identifiers 1

IdentifierTypeStateIssuer
0050-02294OtherNCNC STATE LICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120229000788 NC Practitioner - Nurse Practitioner 4587822010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of North Carolina at Chapel Hill School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carrboro Pediatrics and Internal Medicine PAGroup PAC ID 3476455973, 5 clinicians

Practice addresses (Care Compare)

127 Fidelity St
Carrboro, NC 27510-2002
Phone (919) 933-8381

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5002294NCMDFamily Nurse Practitioner
182242NCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Carrboro Pediatrics and Internal Medicine, PA CurrentSince Mar 10, 2020 Accepting new patients

Locations

127 Fidelity St
Carrboro, NC 27510
Phone (919) 619-4920

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1861574303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 FIDELITY ST",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "275102002",
            "telephone_number": "919-933-8381",
            "fax_number": "919-933-6623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 FIDELITY ST",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "275102002",
            "telephone_number": "919-933-8381",
            "fax_number": "919-933-6623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FURIN",
        "first_name": "KELLIE",
        "middle_name": "WALTER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5002294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC STATE LICENSE",
            "identifier": "0050-02294",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrboro, NC

Sources for this page

Verify at the official NPI Registry.