NPIMap

Individual provider Active NPI

Kelly Hart, PA-C

  • Physician Assistant
  • Elizabethtown, KY
National Provider Identifier
1043648116
Registry record updated Oct 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TC241 Issued in KY
Practice address
103 Financial Drive
Suite 100
Elizabethtown, KY 42701
Phone
(270) 769-0110
Fax
(270) 765-6953
NPI assigned
Oct 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TC241 KY Primary

Addresses

Primary practice location

103 Financial Drive
Suite 100
Elizabethtown, KY 42701

Mailing address

103 Financial Drive
Suite 100
Elizabethtown, KY 42701
Phone (270) 769-0110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
TC241KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yasir LLC PastSince Jul 1, 2020 Accepting new patients
Yasir Saifullah MD PLLC Physician Assistant Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1382918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382918400000",
    "number": "1043648116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 FINANCIAL DRIVE",
            "address_2": "SUITE 100",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "42701",
            "telephone_number": "270-769-0110",
            "fax_number": "270-765-6953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 FINANCIAL DRIVE",
            "address_2": "SUITE 100",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "42701",
            "telephone_number": "270-769-0110",
            "fax_number": "270-765-6953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "KELLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-28",
        "last_updated": "2013-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.