Individual provider Active NPI

Kelly Reed, PA-C, PHARM.D.

  • Physician Assistant
  • Augusta, GA
National Provider Identifier
1093080624
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9453 Issued in GA
Practice address
Au Medical Center 1120 15TH St
Augusta, GA 30912-3357
Phone
(706) 721-8623
Fax
(706) 721-1459
NPI assigned
Mar 15, 2012
Last updated
Nov 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9453 GA Primary
Physician Assistant 363A00000X 1099950 GA
Pharmacist 183500000X RP00006612 NM

Addresses

Primary practice location

Au Medical Center 1120 15TH St
Augusta, GA 30912-3357

Mailing address

1120 15TH St Ste Bi1056
Augusta, GA 30912-0004
Phone (706) 721-3813

Other practice location 1

9901 Medical Center Dr
Rockville, MD 20850-3357
Phone (240) 826-7578

Other names 1

  • Kelly Sue Clapper Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20200624003357 GA Practitioner - Physician Assistant 6608172788 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant, Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
9453GAMDGeneral Practice Dentistry
RP00006612NMMDPharmacist
1099950GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Nov 1, 2023 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Nov 1, 2023 Accepting new patients
Ashwins, LLC PastSince Jun 21, 2020 Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1120 15th St
Bldg O107
Augusta, GA 30912

1120 15th St
Ste BI1056
Augusta, GA 30912
Phone (706) 721-2785

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Organizations & group practices 4

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": "1331769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1093080624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 15TH ST STE BI1056",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-3813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AU MEDICAL CENTER 1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309123357",
            "telephone_number": "706-721-8623",
            "fax_number": "706-721-1459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9901 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Rockville",
            "state": "MD",
            "postal_code": "208503357",
            "country_code": "US",
            "telephone_number": "240-826-7578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REED",
        "first_name": "KELLY",
        "credential": "PA-C, PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-15",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9453",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "1099950",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NM",
            "license": "RP00006612",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "CLAPPER",
            "middle_name": "SUE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.