NPIMap

Individual provider Active NPI

Kelly L. Ross, DO

  • Orthopaedic Surgery Physician
  • Corsicana, TX
National Provider Identifier
1053384818
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
W8090 Issued in TX
Practice address
400 Hospital Dr Ste 201
Corsicana, TX 75110-2489
Phone
(903) 641-4870
Fax
(903) 641-4877
NPI assigned
Feb 10, 2006
Last updated
Aug 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X W8090 TX Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X W8090 TX

Addresses

Primary practice location

400 Hospital Dr Ste 201
Corsicana, TX 75110-2489

Mailing address

400 Hospital Dr Ste 201
Corsicana, TX 75110-2489
Phone (903) 641-4870

Other identifiers 2

IdentifierTypeStateIssuer
207593807MedicaidMO
P00266071OtherMORAIL ROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050927000817 MO Practitioner - Orthopedic Surgery 5193750313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2305 S Hwy 65
Marshall, MO 65340-3702
Phone (660) 831-8414

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
John Fitzgibbon Memorial Hospital, Inc. Current Accepting new patients

Locations

2305 S Highway 65
Marshall, MO 65340
Phone (660) 831-3730

Interoperability endpoints

  • Direct secure messaging: kellyross@fitzgibbon.cernerdirect.com

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.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1053384818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HOSPITAL DR STE 201",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751102489",
            "telephone_number": "903-641-4870",
            "fax_number": "903-641-4877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HOSPITAL DR STE 201",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751102489",
            "telephone_number": "903-641-4870",
            "fax_number": "903-641-4877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "KELLY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "W8090",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TX",
            "license": "W8090",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207593807",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00266071",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corsicana, TX

Sources for this page

Verify at the official NPI Registry.