Kellie Barbara Ann Ploense, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95003840 Issued in CA

Practice address

41945 Big Bear Blvd
Big Bear Lake, CA 92315

Phone

(909) 866-6567

Fax

(909) 866-7025

NPI assigned

Feb 18, 2016

Last updated

Sep 5, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 CA

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

Interoperability endpoints

• Direct secure messaging: kellie.ploense.p2@direct.hvvmg.nextgenshare.com

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.

• Bear Mountain Family Practice

  • Family Medicine Physician
  • Big Bear Lake, CA
  • NPI 1720107592
  NPD (past)
• C. H. Fagan, M.D., Inc

  • Health Service Clinic/Center
  • Big Bear Lake, CA
  • NPI 1487838074
  NPD (past)

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1942669940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 6848",
            "address_2": "PMB 278",
            "city": "BIG BEAR LAKE",
            "state": "CA",
            "postal_code": "92315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41945 BIG BEAR BLVD",
            "city": "BIG BEAR LAKE",
            "state": "CA",
            "postal_code": "92315",
            "telephone_number": "909-866-6567",
            "fax_number": "909-866-7025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOENSE",
        "first_name": "KELLIE",
        "middle_name": "BARBARA ANN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-18",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nisel Pardo-McDonald
• William John Pasquini, D.D.
• Edward T Perry Jr., MD
• Sara Lynn Pfeiffer
• Loretta Rosa Phipps, LMFT
• Poland Chiropractic Office
• Larry E Poland, D.C
• David J Poole, D.D.S.
• Katheryn Poole, DDS
• Dolores Christine Price, CATC

• Family Nurse Practitioner in Big Bear Lake, CA
• Providers in Big Bear Lake, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.