Individual provider Active NPI

Kelsi Fulda, FNP-C

  • Family Nurse Practitioner
  • Marion, IN
National Provider Identifier
1992409478
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71013807A Issued in IN
Practice address
330 N Wabash Ave Ste 210
Marion, IN 46952-2679
Phone
(765) 660-7330
NPI assigned
Mar 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28212485A IN
Family Nurse Practitioner 363LF0000X 71013807A IN Primary

Addresses

Primary practice location

330 N Wabash Ave Ste 210
Marion, IN 46952-2679

Mailing address

441 N Wabash Ave
Marion, IN 46952-2612
Phone (765) 660-7330

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
I20230504001499 IN Practitioner - Nurse Practitioner 3870958481 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
Marion General HospitalGroup PAC ID 9133023625, 115 clinicians

Practice addresses (Care Compare)

330 N Wabash Ave
Marion, IN 46952-2696
Phone (765) 660-6670

Hospital & facility affiliations

  • Marion General Hospital Hospital, Marion, IN, CCN 150011

Merit-based Incentive Payment System (MIPS)

Final score
85.82 of 100Reported as group
Quality
71.45
Promoting interoperability
100
Improvement activities
40
Cost
75.59

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28212485AINMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Marion General Hospital CurrentSince May 1, 2023 Accepting new patients
Marion General Hospital CurrentSince May 1, 2023 Accepting new patients
Marion General Hospital Past Accepting new patients

Locations

4781 Kaybee Dr
Gas City, IN 46933
Phone (765) 660-7840

1406 W Bella Dr
Marion, IN 46953
Phone (765) 660-7470

330 N Wabash Ave
Marion, IN 46952
Phone (765) 662-3320

1136 N Baldwin Ave
Marion, IN 46952
Phone (765) 622-1245

1391 N Baldwin Ave
Marion, IN 46952
Phone (765) 660-7900

330 N Wabash Ave
Ste G-20
Marion, IN 46952
Phone (765) 660-7600

330 N Wabash Ave
Ste 210
Marion, IN 46952
Phone (765) 651-4278

441 N Wabash Ave
Marion, IN 46952
Phone (219) 482-4577

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 4

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": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1992409478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 N WABASH AVE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522612",
            "telephone_number": "765-660-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N WABASH AVE STE 210",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522679",
            "telephone_number": "765-660-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULDA",
        "first_name": "KELSI",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28212485A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71013807A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IN

Sources for this page

Verify at the official NPI Registry.