Individual provider Active NPI

Kelly Reimold, CRNP

  • Nurse Practitioner
  • Wexford, PA
National Provider Identifier
1952754715
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP016250 Issued in PA
Practice address
12311 Perry Hwy
Wexford, PA 15090-8344
Phone
(878) 332-4159
Fax
(878) 332-4479
NPI assigned
Jul 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP016250 PA Primary

Addresses

Primary practice location

12311 Perry Hwy
Wexford, PA 15090-8344

Mailing address

271 State Route 288
Ellwood City, PA 16117-3055

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20161116002662 PA Practitioner - Nurse Practitioner 1557640430 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Hazel LN
Sewickley, PA 15143-1249

2580 Constitution Blvd
Beaver Falls, PA 15010-1294
Phone (724) 843-4700

500 Sharon Rd
Beaver, PA 15009-1957
Phone (724) 728-8751

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP016250PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic Current Accepting new patients
Heritage Valley Multispecialty Group, Inc. Current Accepting new patients
Allegheny Clinic CurrentSince Mar 30, 2022 Accepting new patients
Heritage Valley Multispecialty Group, Inc. Nurse Practitioner CurrentSince Oct 1, 2016 Accepting new patients
Heritage Valley Multispecialty Group, Inc CurrentSince Oct 1, 2016 Accepting new patients
Allegheny Clinic CurrentSince Mar 30, 2022 Accepting new patients

Locations

500 Sharon Rd
Beaver, PA 15009
Phone (724) 728-7683

2 Peartree Way
Beaver, PA 15009
Phone (724) 773-6802

271 State Route 288
Ellwood City, PA 16117
Phone (724) 773-4681

62 Greenbriar Dr
Ste 1
Leechburg, PA 15656
Phone (724) 845-7765

12311 Perry Hwy
Wexford, PA 15090
Phone (878) 332-4143

Organizations & group practices 6

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 3

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": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1952754715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 STATE ROUTE 288",
            "city": "ELLWOOD CITY",
            "state": "PA",
            "postal_code": "161173055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12311 PERRY HWY",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150908344",
            "telephone_number": "878-332-4159",
            "fax_number": "878-332-4479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIMOLD",
        "first_name": "KELLY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-18",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP016250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wexford, PA

Sources for this page

Verify at the official NPI Registry.