| Kelly E Crowley, NP | |
|
12563 State Road 23, Granger, IN 46530-9226 | |
| (574) 335-8300 | |
| (574) 335-0775 |
| Full Name | Kelly E Crowley |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 3 Years |
| Location | 12563 State Road 23, Granger, Indiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730836982 | NPI | - | NPPES |
| 1102193309 | Other | IN | ANTHEM BCBS |
| 300064808 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 71012221A (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Saint Joseph Regional Medical Center | Mishawaka, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Saint Joseph Regional Medical Center Inc | 8325950843 | 101 |
| Entity Name | Saint Joseph Regional Medical Center-south Bend Campus Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1841245594 PECOS PAC ID: 3476451790 Enrollment ID: O20031223000724 |
| Entity Name | The South Bend Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073680419 PECOS PAC ID: 3779577937 Enrollment ID: O20040412000439 |
| Entity Name | Saint Joseph Regional Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225082878 PECOS PAC ID: 8325950843 Enrollment ID: O20040708000757 |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly E Crowley, NP 707 Cedar St Ste 405, South Bend, IN 46617-2059 Ph: (574) 335-8707 | Kelly E Crowley, NP 12563 State Road 23, Granger, IN 46530-9226 Ph: (574) 335-8300 |
Megan Vermilyer, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6913 N Main St, Granger, IN 46530 Phone: 574-647-1500 | |
Rebecca L Allen-legault, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6910 N Main St Unit 52, Granger, IN 46530 Phone: 574-231-6766 Fax: 833-249-2411 | |
Dr. Sara Golden, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6913 N Main St, Granger, IN 46530 Phone: 574-647-1500 | |
Mrs. Tamara L Riess, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6913 N Main St, Granger, IN 46530 Phone: 574-647-1550 Fax: 574-243-4306 | |
Emily Peak, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 52500 Fir Rd, Granger, IN 46530 Phone: 574-234-8161 | |
Roni Aizigov, CRNA, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 51050 Bittersweet Rd Ste B, Granger, IN 46530 Phone: 718-208-0446 Fax: 574-244-0240 | |
Kristi M Troyer, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 621 Memorial Dr, Ste 403, Granger, IN 46601 Phone: 574-647-1405 Fax: 574-647-3970 |