Kelly Marie Parker, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1882 Issued in AZ

Practice address

1920 E Cambridge Ave Ste 302
Phoenix, AZ 85006-1464

Phone

(602) 933-5200

Fax

(602) 933-4272

NPI assigned

Jan 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kelly Marie Matthews 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, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoenix Children'S HospitalGroup PAC ID 0446278584, 431 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Phoenix Children'S Hospital

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1922112044
  Medicare reassignment Care Compare group NPD (past)
• Phoenix Children'S Medical Group

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1487814240
  NPD

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1093795064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E CAMELBACK RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182327",
            "telephone_number": "602-933-1814",
            "fax_number": "602-933-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 E CAMBRIDGE AVE STE 302",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850061464",
            "telephone_number": "602-933-5200",
            "fax_number": "602-933-4272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1920 E. Cambridge Ave",
            "address_2": "# 302",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "85006",
            "country_code": "US",
            "telephone_number": "602-279-1697",
            "fax_number": "602-264-0461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKER",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "1882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "317281-04",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MATTHEWS",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jason Allan Parker
• Jeffrey B. Parker, MD
• Jeremy Parker, MS
• Joel E Parker, M.D.
• Jose Rene Parker, MD
• Kiara Parker, MA, T-LAC
• Kristen Parker
• Lamia Parker
• Matthew Gerard Parker, M.D.
• Raleisa Parker, LPC

• Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2018; 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.