Kelly Evans, D.O.
Individual provider Active NPI Internal Medicine Physician · Manchester, KY
NPI 1124107693 · NPPES record last updated Jan 17, 2019
Key facts
- NPI
- 1124107693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 02584 (KY)
- Practice address
- 85 Highway 80
Manchester, KY 40962-8801 - Phone
- (606) 596-0410
- Fax
- (606) 528-8272
- NPI assigned
- Nov 3, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Philadelphia College of Osteopathic Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Grace Community Health Center, Inc.
Practice addresses (Care Compare)
14662 N US Hwy 25 E
Corbin, KY 40701-6425
Phone (606) 526-9005
313 S Cherry St
Pineville, KY 40977-1724
Phone (606) 654-3338
85 Hwy 80
Manchester, KY 40962-8801
Phone (606) 596-0410
Hospital & facility affiliations
- Hospice of the Bluegrass, Inc.
- AdventHealthManchester
- Mary Breckinridge Arh Hospital
- Kentucky River Medical Center
- Owsley County Health Care Center, Inc.
- Landmark of Laurel Creek Rehabilitation and Nursin
- Hyden Health and Rehabilitation Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070822000548 | KY | Practitioner - Family Practice | 9830281880 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grace Community Health Center, Inc. | Current | Accepting new patients | |
| Grace Community Health Center, Inc. | Current |
Accepting new patients | |
| Grace Community Health Center Inc | Current |
Accepting new patients | |
| Parkway Medical Clinic | Past | Accepting new patients | |
| Owsley County Health Care Center, Inc. | Past | Accepting new patients | |
| Landmark of Laurel Creek Rehabilitation and Nursing Center | Past | Accepting new patients |
Locations
1019 Cumberland Falls Hwy
Ste B201
Corbin, KY 40701
14662 N US Highway 25 E
Corbin, KY 40701
Phone (606) 526-9005
39 Cumberland Gap Plz
Gray, KY 40734
Phone (606) 526-9005
21154 Highway 421
Ste 1
Hyden, KY 41749
272 London Mountain View Dr
London, KY 40741
Phone (606) 231-2614
934 S Laurel Rd
Ste 1
London, KY 40744
Phone (606) 526-8604
85 Highway 80
Manchester, KY 40962
Phone (606) 596-0410
1033 N Highway 11
Manchester, KY 40962
Phone (606) 598-6163
313 S Cherry St
Pineville, KY 40977
Phone (606) 654-3338
Interoperability endpoints
- kevans704616@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 02584 | KY | Yes |
Addresses
Primary practice location
85 Highway 80
Manchester, KY 40962-8801
Mailing address
1019 Cumberland Falls Hwy
Suite B201
Corbin, KY 40701-2735
Phone (606) 526-9005
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64012206 | Medicaid | KY |
Other providers in Manchester, KY
- East Bernstadt Medical Clinic PLLC
- Edwards Clinic, PSC
- Dana Phillip Edwards
- Eva Angel Edwards
- Ahmed El Gammal
- Express Care Pharmacy LLC
- Faith Medical Center LLC
- Family Clinic Manchaster LLC
- Family Health Care Associates
- Family Health Care Associates of Kentucky, Inc.
All providers in Manchester, KY · Internal Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2019. 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.