Individual provider Active NPI

Kelly J. McElligott, AU.D., CCC-A

  • Audiologist
  • North Chesterfield, VA
National Provider Identifier
1104342864
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2201002004 Issued in VA
Practice address
9513 Amberdale Dr
North Chesterfield, VA 23236-1256
Phone
(804) 373-8224
Fax
(804) 369-9658
NPI assigned
Aug 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2201002004 VA Primary

Addresses

Primary practice location

9513 Amberdale Dr
North Chesterfield, VA 23236-1256

Mailing address

9513 Amberdale Dr
North Chesterfield, VA 23236-1256
Phone (804) 373-8224

Other identifiers 1

IdentifierTypeStateIssuer
2201002004OtherVASTATE AUDIOLOGY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180521000455 TN Practitioner - Qualified Audiologist 1557626678 Reassigns benefits to 1 organization
I20250225002785 VA Practitioner - Qualified Audiologist 1557626678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
University of Tennessee, HSC, College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inspired Hearing Solutions PLLCGroup PAC ID 8224458054, 2 clinicians

Practice addresses (Care Compare)

9513 Amberdale Dr
North Chesterfield, VA 23236-1256
Phone (804) 373-8224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Inspired Hearing Solutions, PLLC Audiologist CurrentSince Jan 20, 2025 Accepting new patients
Tennessee Ear, Nose & Throat Consultants, PC Audiologist CurrentSince Oct 14, 2017 Accepting new patients
Allergy Associates, P.a. PastSince Jul 1, 2022 Accepting new patients

Locations

9430 Park West Blvd
Ste 330
Knoxville, TN 37923
Phone (865) 271-6534

9430 Park West Blvd
Ste 335
Knoxville, TN 37923
Phone (865) 693-6065

Dept 888604
Knoxville, TN 37995

576 Fort Loudoun Med Center Dr
Ste 207
Lenoir City, TN 37772
Phone (865) 271-6534

9513 Amberdale Dr
North Chesterfield, VA 23236
Phone (804) 373-8224

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1104342864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9513 AMBERDALE DR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232361256",
            "telephone_number": "804-373-8224",
            "fax_number": "804-369-9658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9513 AMBERDALE DR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232361256",
            "telephone_number": "804-373-8224",
            "fax_number": "804-369-9658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCELLIGOTT",
        "first_name": "KELLY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "AU.D., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-15",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201002004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE AUDIOLOGY LICENSE",
            "identifier": "2201002004",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chesterfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.