Kelli Renee Wilder-Outlaw, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

F431324 Issued in NY

Practice address

601 Elmwood Ave
Rochester, NY 14642-0001

Phone

(585) 275-6026

NPI assigned

Jul 4, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Frederick Ferris Thompson HospitalGroup PAC ID 3274428586, 227 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• F F Thompson Hospital Hospital, Canandaigua, NY, CCN 330074

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.

• The Frederick Ferris Thompson Hospital

  • General Acute Care Hospital
  • Canandaigua, NY
  • NPI 1194776351
  Medicare reassignment Care Compare group NPD
• U of R Neurology Department

  • Neurology Physician
  • Rochester, NY
  • NPI 1184725525
  Medicare reassignment NPD
• University of Rochester

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1710226824
  Medicare reassignment NPD
• Acute Care Trauma of the University of Rochester

  • Surgical Critical Care Physician
  • Rochester, NY
  • NPI 1851754634
  NPD
• Cardiac Surgery of the University of Rochester

  • Surgical Critical Care Physician
  • Rochester, NY
  • NPI 1689023277
  NPD
• The Frederick Ferris Thompson Hospital

  dba UR Medicine Thompson Health Victor Medical Group Pharmacy

  • Community/Retail Pharmacy
  • Victor, NY
  • NPI 1831914274
  NPD
• University of Rochester

  dba Strong Memorial Hospital-University of Rochester

  • Community/Retail Pharmacy
  • Rochester, NY
  • NPI 1598476269
  NPD
• University of Rochester

  dba Strong Memorial Hospital MD Group

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1821152588
  NPD

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

• The Frederick Ferris Thompson Hospital

  • General Acute Care Hospital
  • Canandaigua, NY
  • NPI 1194776351
  Care Compare affiliation

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

{
    "created_epoch": "1530662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1952897779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3082 WHEELER STATION RD",
            "city": "BLOOMFIELD",
            "state": "NY",
            "postal_code": "144699215",
            "telephone_number": "585-746-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-275-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER-OUTLAW",
        "first_name": "KELLI",
        "middle_name": "RENEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-04",
        "last_updated": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F431324",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "431324",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwilderoutlaw81736@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emma Wilcox, MD
• Eric Wilcox, DO
• Nancy LM Wilcox, FNP
• Brandon Jeffrey Wilcoxson, M.D.
• Sallie Wild
• Allison Marie Wildey, REGISTERED NURSE
• Kelcy Wildt, PA
• Gina Wiley, MS, OTR/L
• Alexyn Marie Wilford, LCSW
• Nancy C Wilk, N.P.

• Acute Care Nurse Practitioner in Rochester, NY
• Providers in Rochester, NY by specialty
• Acute Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.
• 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.