Krystal Rennee Kackley, AGAC-NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

129430 Issued in MT

Practice address

1101 26TH St S
Great Falls, MT 59405-5161

Phone

(406) 731-8888

Fax

(406) 731-8876

NPI assigned

Apr 30, 2018

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in KY, MT2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Benefis Hospitals IncGroup PAC ID 1153235296, 390 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Benefis Hospitals Inc Hospital, Great Falls, MT, CCN 270012
• Northern Montana Hospital Hospital, Havre, MT, CCN 271348
• P H S Indian Hospital at Browning - Blackfeet Hospital, Browning, MT, CCN 270074
• St Peters Health Hospital, Helena, MT, CCN 270003

Merit-based Incentive Payment System (MIPS)

Final score

82.99 of 100Reported as group

Quality

62.64

Promoting interoperability

100

Improvement activities

40

Cost

80.67

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Benefis Hospitals Inc

  • Multi-Specialty Clinic/Center
  • Great Falls, MT
  • NPI 1780968974
  Medicare reassignment Care Compare group NPD
• University of Kentucky

  • Diagnostic Radiology Physician
  • Lexington, KY
  • NPI 1770771974
  Medicare reassignment NPD
• Benefis Hospitals, Inc.

  • General Acute Care Hospital
  • Great Falls, MT
  • NPI 1881650737
  NPD (past)

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

• Benefis Hospitals Inc

  • Multi-Specialty Clinic/Center
  • Great Falls, MT
  • NPI 1780968974

  Hospital

  Care Compare affiliation
• Benefis Hospitals, Inc.

  • Air Ambulance
  • Great Falls, MT
  • NPI 1114934023

  Hospital

  Care Compare affiliation
• Benefis Hospitals, Inc.

  • General Acute Care Hospital
  • Great Falls, MT
  • NPI 1881650737
  Care Compare affiliation
• Northern Montana Hospital

  • Critical Access Hospital
  • Havre, MT
  • NPI 1427059070
  Care Compare affiliation
• St Peter'S Medical Group North

  • Family Medicine Physician
  • Helena, MT
  • NPI 1477844744

  Hospital

  Care Compare affiliation
• St. Peter'S Health

  • Family Medicine Physician
  • Helena, MT
  • NPI 1083869390

  Hospital

  Care Compare affiliation
• St. Peter'S Health

  • General Acute Care Hospital
  • Helena, MT
  • NPI 1528023520
  Care Compare affiliation
• St. Peter'S Hospital

  • Ambulance
  • Helena, MT
  • NPI 1760586481

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1902394455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 26TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594055161",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 26TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594055161",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACKLEY",
        "first_name": "KRYSTAL",
        "middle_name": "RENNEE",
        "credential": "AGAC-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-30",
        "last_updated": "2024-04-08",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MT",
            "license": "129430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "benefishealthsystem@direct.summit-healthcare.org",
            "affiliation": "Y",
            "affiliationName": "Benefis Hospitals Inc",
            "address_1": "1101 26th St S",
            "city": "Great Falls",
            "state": "MT",
            "country_code": "US",
            "postal_code": "594055161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkackley19060@benefishs.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Benefis Hospitals Inc",
            "address_1": "1101 26th St S",
            "city": "Great Falls",
            "state": "MT",
            "country_code": "US",
            "postal_code": "594055161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Acute Care Nurse Practitioner in Great Falls, MT
• Providers in Great Falls, MT by specialty
• Acute Care Nurse Practitioner in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.