Rebecca B Kelley, M.D.
Individual provider Active NPI Family Medicine Physician · Centralia, MO
NPI 1023099579 · NPPES record last updated Dec 1, 2022
Key facts
- NPI
- 1023099579
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 106418 (MO)
- Practice address
- 1021 E Highway 22
Centralia, MO 65240-1183 - Phone
- (573) 682-5588
- Fax
- (573) 682-1539
- NPI assigned
- Nov 10, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Missouri, Columbia School of Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Boone Physician Services LLC
Practice addresses (Care Compare)
1021 E Hwy 22
Centralia, MO 65240-1183
Phone (573) 682-5588
Hospital & facility affiliations
- Boone Hospital Center
- University of Missouri Health Care
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100524000534 | MO | Practitioner - Family Practice | 4385554658 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106418 | MO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boone Physician Services, LLC | Current |
Accepting new patients | |
| Family Healthcare of Auxvasse PC | Family Medicine | Current |
Accepting new patients |
Locations
1021 E Highway 22
Centralia, MO 65240
Phone (573) 682-5580
1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000
1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119
300 N Morley St
Ste A
Moberly, MO 65270
Phone (660) 263-1225
300 N Morley St
Ste Ac
Moberly, MO 65270
Phone (660) 263-1225
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 106418 | MO | Yes |
Addresses
Primary practice location
1021 E Highway 22
Centralia, MO 65240-1183
Mailing address
1021 E Highway 22
Centralia, MO 65240-1183
Phone (573) 582-5588
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 208727727 | Medicaid | MO | |
| 263971 | Other | RURAL HEALTHCARE CLINIC |
Other providers in Centralia, MO
- Alyssa Hatcher
- Rachael L Hayden
- Health Services Administration, Inc
- Randal Dean Huhmann
- Jennifer Lynn Isringhausen
- Allison Nichole Kemble
- Curtis David King
- Kinkead Pharmacy, Inc.
- Trevor Matthew Kinkead
- Wendy Sue Kinkead
All providers in Centralia, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.