Kelly Marie Pesis, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA718 Issued in KY

Practice address

289 Ireland Ave
Ireland Army Community Hospital
Fort Knox, KY 40121-5111

Phone

(502) 624-9007

Fax

(502) 624-0252

NPI assigned

Jan 26, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• American Current Care PA

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1720262645

  KY

  Medicare reassignment NPD
• American Current Care P.a.

  • Urgent Care Clinic/Center
  • Beaumont, TX
  • NPI 1376356568
  NPD

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1114073939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 IRELAND AVE",
            "address_2": "IRELAND ARMY COMMUNITY HOSPITAL",
            "city": "FORT KNOX",
            "state": "KY",
            "postal_code": "401215111",
            "telephone_number": "502-624-9007",
            "fax_number": "502-624-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 IRELAND AVE",
            "address_2": "IRELAND ARMY COMMUNITY HOSPITAL",
            "city": "FORT KNOX",
            "state": "KY",
            "postal_code": "401215111",
            "telephone_number": "502-624-9007",
            "fax_number": "502-624-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESIS",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy L Parry
• John J. Parsley, PSYD
• Gina Michelle Pawley-Whitley, LCSW
• Cynthia Lorraine Pearson, NURSE PRACTITIONER
• Andres Perez, MD
• Robert M Peters Jr., PA-C
• Emmanuel Asamoah Prah, MPAS, PA-C
• Tami M Prince, M.D.
• John W Rauch, D.D.S.02
• Dayna Ray, APRN

• Physician Assistant in Fort Knox, KY
• Providers in Fort Knox, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.