Kelly Marie Weary, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP009943 Issued in PA

Practice address

2500 Palermo Drive Suite 4
Erie, PA 16506-7205

Phone

(814) 860-3179

Fax

(814) 616-7400

NPI assigned

Sep 24, 2008

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 PA

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

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571961600000",
    "number": "1891945093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 PALERMO DRIVE SUITE 4",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165067205",
            "telephone_number": "814-860-3179",
            "fax_number": "814-616-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 PALERMO DRIVE SUITE 4",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165067205",
            "telephone_number": "814-860-3179",
            "fax_number": "814-616-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEARY",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-24",
        "last_updated": "2019-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP009943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Lee Waugaman
• Kathryn Wawrzyniak
• Morgan Wawrzyniak
• Gracie Lee Wayland
• Alexander Wayne
• Emily Weaver, PA-C
• Matthew Webb
• Shelly Webb
• Justin Webber, D.O.
• Keith Webber, ATC

• Family Nurse Practitioner in Erie, PA
• Providers in Erie, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; 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.