Kailey R Kelly, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

11343 Issued in AZ

Practice address

1955 W Frye Rd
Chandler, AZ 85224-6282

Phone

(480) 728-3000

Fax

(480) 728-4747

NPI assigned

Nov 8, 2022

Last updated

Nov 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Kailey Renee Green Former name

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sjhmc Physician ServicesGroup PAC ID 4486646197, 645 clinicians

Chandler Regional Medical CenterGroup PAC ID 5395729784, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002
• Chandler Regional Medical Center Hospital, Chandler, AZ, CCN 030036

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Chandler Regional Medical Center

  dba CRMC Trauma Services

  • Emergency Care Clinic/Center
  • Chandler, AZ
  • NPI 1871910968
  Medicare reassignment Care Compare group NPD
• Sjhmc Physician Services

  dba St. Joseph's Faculty Physicians

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1326098005
  Medicare reassignment Care Compare group NPD
• St. Joseph's Hospital and Medical Center

  dba SJHMC Trauma Services

  • Emergency Care Clinic/Center
  • Phoenix, AZ
  • NPI 1255382412
  NPD
• Carolina Behavioral Care, PA

  • Psychiatry Physician
  • Hillsborough, NC
  • NPI 1487709861
  NPD (past)
• Carolina Behavioral Care, PA

  • Psychiatry Physician
  • Pinehurst, NC
  • NPI 1982642393
  NPD (past)

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

• Dignity Community Care

  dba Chandler Regional Medical Center

  • General Acute Care Hospital
  • Chandler, AZ
  • NPI 1700910189
  Care Compare affiliation
• Asante Three Rivers Medical Center, LLC

  • General Acute Care Hospital
  • Grants Pass, OR
  • NPI 1801891809
  Care Compare affiliation

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1033827175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 W FRYE RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246282",
            "telephone_number": "480-728-3000",
            "fax_number": "480-728-4747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 SW Ramsey Avenue",
            "address_purpose": "LOCATION",
            "city": "Grants Pass",
            "state": "OR",
            "postal_code": "975275554",
            "country_code": "US",
            "telephone_number": "541-472-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KAILEY",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-08",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "11343",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA214290",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "11343",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAILEY",
            "last_name": "GREEN",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katherine Chemodurow Kelley, M.D.
• Keith Michael Kelley, APRN-RNP, FNP-C
• Mackenzie Kelley
• Christopher M Kellogg, MD
• David Norris Kells, M.D.
• Melanie Mercedes Kelly, PA-C
• Courtney G Kelm, PAC
• Sandra Kay Kelman, WHNP-BC-NP
• Ella Kelsay
• Melissa Kelsey, D.O.

• Surgical Physician Assistant in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Surgical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; 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.