Carly R. Beckner, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1586 Issued in KY

Practice address

1065 Ashley St Ste 200
Bowling Green, KY 42103-3401

Phone

(270) 843-3376

Fax

(270) 393-2737

NPI assigned

Dec 19, 2010

Last updated

Jan 21, 2025By the provider in NPPES

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

• Carly R. Donnelly Former name

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

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Graves Gilbert Clinic PLLCGroup PAC ID 4082511167, 207 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carlybeckner@ggc.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Graves Gilbert Clinic PLLC

  dba Graves Gilbert Clinic

  • Specialist
  • Bowling Green, KY
  • NPI 1114948288

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Graves Gilbert Clinic PLLC

  dba GGC Rural Health Clinic Cave City

  • Rural Health Clinic/Center
  • Cave City, KY
  • NPI 1104635663
  NPD

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

{
    "created_epoch": "1292716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1194028894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011759",
            "telephone_number": "270-781-3910",
            "fax_number": "270-842-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 ASHLEY ST STE 200",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421033401",
            "telephone_number": "270-843-3376",
            "fax_number": "270-393-2737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 Fairway St",
            "address_purpose": "LOCATION",
            "city": "Bowling Green",
            "state": "KY",
            "postal_code": "421032477",
            "country_code": "US",
            "telephone_number": "270-781-3910",
            "fax_number": "270-842-7177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BECKNER",
        "first_name": "CARLY",
        "middle_name": "R.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-19",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100200050",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "DONNELLY",
            "middle_name": "R.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shelby Malynn Beauchamp, RBT
• Abigail Becker, RBT
• Angela Becker
• Joe Frederick Beckman, R.PH.
• Joseph Ryan Beckman, DO
• Maliyah Thais-Sincere Beckwith, MS, CF-SLP; BS, RBT
• Nicholas Bedwell
• Constance Lachele Begley, OTR
• Janice Belcher
• Chase Andrew Beliles, MD

• Physician Assistant in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.