Individual provider Active NPI

Kelsey Panter Lance

  • Family Nurse Practitioner
  • Blue Ridge, GA
National Provider Identifier
1881361772
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN275291 Issued in GA
Practice address
4799 Blue Ridge Dr Ste 104
Blue Ridge, GA 30513-3468
Phone
(706) 632-1155
Fax
(706) 896-0877
NPI assigned
Aug 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X RN275291 GA Primary

Addresses

Primary practice location

4799 Blue Ridge Dr Ste 104
Blue Ridge, GA 30513-3468

Mailing address

346 Deep South Farm Rd Ste a
Blairsville, GA 30512-2218
Phone (706) 745-9417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20210903002136 GA Practitioner - Nurse Practitioner 1254737968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Georgia Medicine LLCGroup PAC ID 6406923739, 16 clinicians

Practice addresses (Care Compare)

346 Deep S Farm Rd
Suite a
Blairsville, GA 30512-2218
Phone (706) 745-9417

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Georgia Medicine LLC Single Specialty CurrentSince Aug 1, 2021 Accepting new patients

Locations

346 Deep South Farm Rd
#A
Blairsville, GA 30512
Phone (706) 745-9417

4799 Blue Ridge Dr
Ste 104
Blue Ridge, GA 30513
Phone (706) 492-3200

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1881361772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 DEEP SOUTH FARM RD STE A",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305122218",
            "telephone_number": "706-745-9417",
            "fax_number": "706-896-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4799 BLUE RIDGE DR STE 104",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305133468",
            "telephone_number": "706-632-1155",
            "fax_number": "706-896-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCE",
        "first_name": "KELSEY",
        "middle_name": "PANTER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-27",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN275291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Ridge, GA

Sources for this page

Verify at the official NPI Registry.