Individual provider Active NPI

Kelly Jo Simpson, NP

  • Nurse Practitioner
  • Goshen, IN
National Provider Identifier
1982318002
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71013556A Issued in IN
Practice address
1122 Professional Dr
Goshen, IN 46526-3819
Phone
(574) 533-0560
Fax
(574) 533-1716
NPI assigned
Jan 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 71013556A IN
Nurse Practitioner 363L00000X 71013556A IN Primary

Addresses

Primary practice location

1122 Professional Dr
Goshen, IN 46526-3819

Mailing address

1122 Professional Dr
Goshen, IN 46526-3819
Phone (574) 533-0560

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address simpsonnp.kelly.p1@direct.goshenphysicians.nextgenshare.com
Direct Messaging Address kelly.simpson@goshenhealthdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20230216000510 IN Practitioner - Nurse Practitioner 5395117543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goshen Health System IncGroup PAC ID 4880598572, 135 clinicians

Practice addresses (Care Compare)

1122 Professional Dr
Goshen, IN 46526-3819
Phone (574) 533-0560

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71013556AINMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Goshen Hospital Association Inc Current Accepting new patients
Goshen Health System Inc CurrentSince Mar 1, 2023 Accepting new patients
Goshen Health System Inc Nurse Practitioner CurrentSince Mar 1, 2023 Accepting new patients

Locations

1122 Professional Dr
Goshen, IN 46526
Phone (574) 533-0348

2824 Elkhart Rd
Goshen, IN 46526
Phone (574) 534-6752

Interoperability endpoints

  • Direct secure messaging: kelly.simpson@goshenhealthdirect.com

Organizations & group practices 3

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 1

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": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1982318002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 PROFESSIONAL DR",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465263819",
            "telephone_number": "574-533-0560",
            "fax_number": "574-533-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 PROFESSIONAL DR",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465263819",
            "telephone_number": "574-533-0560",
            "fax_number": "574-533-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "KELLY",
        "middle_name": "JO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IN",
            "license": "71013556A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71013556A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "simpsonnp.kelly.p1@direct.goshenphysicians.nextgenshare.com",
            "affiliation": "N",
            "address_1": "1122 Professional Dr",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465263819",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelly.simpson@goshenhealthdirect.com",
            "affiliation": "N",
            "endpointDescription": "Effective 5/15/23",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1122 Professional Dr",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465263819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

Verify at the official NPI Registry.