Kelly Ann Carothers, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

40256 Issued in WI

Practice address

1836 South Ave
La Crosse, WI 54601-5429

Phone

(608) 782-7300

NPI assigned

Mar 29, 2007

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

Other identifiers 1

Other names 1

• Kelly Ann Staude Former name

Medicare fee-for-service enrollment

Enrolled in WI, MN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Emergency Medicine

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gundersen Lutheran Medical Center IncGroup PAC ID 2163331414, 888 clinicians

Saint Elizabeths Hospital of Wabasha IncGroup PAC ID 5092619387, 93 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Elizabeth Medical Center Hospital, Wabasha, MN, CCN 241335

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kcarothers527045@direct.emplifyhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gundersen Lutheran Medical Center Inc

  dba Emplify Health Hamilton Clinic

  • Clinic/Center
  • La Crosse, WI
  • NPI 1225873458
  Medicare reassignment Care Compare group NPD
• Saint Elizabeths Hospital of Wabasha Inc

  dba Gundersen St. Elizabeth's Hospital and Clinics

  • Critical Access Hospital
  • Wabasha, MN
  • NPI 1659355600
  Medicare reassignment Care Compare group NPD
• Memorial Hospital of Boscobel

  dba Gundersen Boscobel Area Hospital and Clinics

  • Critical Access Hospital
  • Boscobel, WI
  • NPI 1760459846
  Medicare reassignment NPD
• Moundview Memorial Hospital & Clinics, Inc

  dba Gundersen Moundview Hospital and Clinics, Inc.

  • Critical Access Hospital
  • Friendship, WI
  • NPI 1710939533

  Family Medicine

  Medicare reassignment NPD
• St. Joseph's Health Services, Inc.

  • Clinic/Center
  • Hillsboro, WI
  • NPI 1104031798
  Medicare reassignment NPD
• Tri-County Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Whitehall, WI
  • NPI 1417201864
  Medicare reassignment NPD
• Gundersen Lutheran Medical Center Inc

  dba Emplify Health La Crosse Hospital

  • General Acute Care Hospital
  • La Crosse, WI
  • NPI 1376593442

  MN

  Medicare reassignment
• Gundersen Lutheran Medical Center, Inc

  dba Emplify Health Onalaska Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
  • NPI 1871837567
  NPD
• Gundersen Lutheran Medical Center, Inc.

  dba Emplify Health La Crosse Hospital DME

  • Durable Medical Equipment & Medical Supplies
  • La Crosse, WI
  • NPI 1447478607
  NPD
• Memorial Hospital of Boscobel

  • Medicare Defined Swing Bed Hospital Unit
  • Boscobel, WI
  • NPI 1497712624
  NPD
• Moundview Memorial Hospital & Clinics, Inc.

  dba Gundersen Moundview Hospital and Clinics

  • Clinic Pharmacy
  • Friendship, WI
  • NPI 1669056693
  NPD
• Moundview Memorial Hospital & Clinics, Inc.

  dba Gundersen Moundview Hospital and Clinics, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Friendship, WI
  • NPI 1720147366
  NPD

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

• Saint Elizabeths Hospital of Wabasha Inc

  dba Gundersen St. Elizabeth's Hospital and Clinics

  • Critical Access Hospital
  • Wabasha, MN
  • NPI 1659355600
  Care Compare affiliation

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1003936857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAROTHERS",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "40256",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "40256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32474400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "STAUDE",
            "middle_name": "ANN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adam Leland Carlson, CRNA
• Bethany Carlson, MS, CCC-SLP
• Jesse Carlson
• Trinity Rose Carlson
• Logan Daniel Carmichael
• Caitlin Rae Carpenter, PA-C, MPAS
• Leah Rene Carpenter, RN
• Craig C Carr, MD
• Scott Collins Carrington, D.P.M
• Jacqueline Ann Carroll, ADN

• Emergency Medicine Physician in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.