Kellie Clayton Bagi, CRNP
Individual provider Active NPI Nurse Practitioner · Montgomery, AL
NPI 1093368631 · NPPES record last updated Jan 9, 2023
Key facts
- NPI
- 1093368631
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 1-148539 (AL)
- Practice address
- 2065 E South Blvd Ste 201
Montgomery, AL 36116-2460 - Phone
- (334) 747-7250
- Fax
- (334) 747-7270
- NPI assigned
- Jul 23, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 12
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of Alabama School of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Health Care Authority for Baptist Health, an Affiliate of Uabhs
Practice addresses (Care Compare)
2065 E S Blvd
Suite 201
Montgomery, AL 36116-2460
Phone (334) 747-7250
Hospital & facility affiliations
- Baptist Medical Center South
- Baptist Medical Center East
- Prattville Baptist Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 83 of 100
- Quality
- 64.43
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 78.9
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200803002890 | AL | Practitioner - Nurse Practitioner | 5597180851 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Care Authority for Baptist Health, an Affiliate of Uabhs | Current |
Accepting new patients | |
| Health Care Authority for Baptist Health, an Affiliate of Uabhs | Current | Accepting new patients | |
| Health Care Authority for Baptist Health, an Affiliate of Uabhs | Neurology | Current |
Accepting new patients |
| The Health Care Authority for Baptist Health an Affiliate of Uabhs | Past | Accepting new patients | |
| Neurological Care Center of Montgomery PC | Neurology | Past |
Accepting new patients |
Locations
2055 E South Blvd
Ste 308
Montgomery, AL 36116
Phone (334) 286-2390
2065 E South Blvd
Ste 201
Montgomery, AL 36116
Phone (334) 281-9172
2065 E South Blvd
Ste 301
Montgomery, AL 36116
Phone (334) 747-7250
2055 E South Blvd
Ste 200
Montgomery, AL 36116
Phone (334) 284-5211
301 Brown Springs Rd
Montgomery, AL 36117
Phone (334) 273-4159
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1-148539 | AL | Yes |
Addresses
Primary practice location
2065 E South Blvd Ste 201
Montgomery, AL 36116-2460
Mailing address
301 Brown Springs Rd
Montgomery, AL 36117-7005
Phone (334) 747-4159
Other practice location 1
1315 Mulberry St
Montgomery, AL 36106-1132
Phone (334) 262-1113
Other providers in Montgomery, AL
- Sheila Shaffer Babcock
- Lisa Bachant
- Back to Health
- Jungha Back
- Blake William Badillo
- Bernita Lashell Bailey
- Collin Conroy Bailey
- Jace Bailey
- Joseph M Bailey
- Nancy Elizabeth Bailey
All providers in Montgomery, AL · Nurse Practitioner in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2023. 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.