Kelsie Dee Creevan, APRN-FNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

114836 Issued in NE

Practice address

116 E H St
Wymore, NE 68466-1702

Phone

(402) 645-3310

NPI assigned

Jun 22, 2023

Sex

Female

Sole proprietor

Yes

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.

• Beatrice Community Hospital & Health Center Inc

  • Emergency Medicine Physician
  • Beatrice, NE
  • NPI 1922111855

  NE

  Medicare reassignment NPD

Medicare fee-for-service enrollment

Enrolled in NE

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kcreevan156959@direct.nebraskamed.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 22, 2023.

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1912683228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39646 STATE HIGHWAY 112",
            "city": "WYMORE",
            "state": "NE",
            "postal_code": "684668028",
            "telephone_number": "402-806-7625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 E H ST",
            "city": "WYMORE",
            "state": "NE",
            "postal_code": "684661702",
            "telephone_number": "402-645-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREEVAN",
        "first_name": "KELSIE",
        "middle_name": "DEE",
        "name_prefix": "Mrs.",
        "credential": "APRN-FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NE",
            "license": "114836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly S Barnard
• Beatrice Community Hospital & Health Center Inc
• Deelynne Gayle Bednar, LMHP
• Alice Jane Bryan
• City of Wymore
• Lisa Lynne Decker, APRN-NP
• Donald Lee Harmon, P.A.
• Hope-Wymore Inc
• Nevauh Marie Livingston
• Rylee Jane Meints

• All providers in Wymore, NE
• Primary Care Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.