Kelly Ann Botta, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110003257 Issued in VA

Practice address

340 N Pleasant Valley Rd
Winchester, VA 22601-5608

Phone

(406) 926-1325

Fax

(540) 900-0959

NPI assigned

Feb 25, 2010

Last updated

Apr 14, 2023By 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 2

Addresses

Electronic endpoints 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2022 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kbotta124183@soc.inova.org

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.

• Valley Regional Enterprises, Inc

  dba Valley Health Quick Care

  • Urgent Care Clinic/Center
  • Strasburg, VA
  • NPI 1063666196
  NPD (past)
• Warren Memorial Hospital, Inc.

  dba Urgent Care Center

  • General Practice Physician
  • Front Royal, VA
  • NPI 1407012982
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1267056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1215259668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 N PLEASANT VALLEY RD PO BOX 4164",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "22601",
            "telephone_number": "540-692-6132",
            "fax_number": "540-900-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 N PLEASANT VALLEY RD",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226015608",
            "telephone_number": "406-926-1325",
            "fax_number": "540-900-0959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 Merchant St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226034772",
            "country_code": "US",
            "telephone_number": "540-536-5950",
            "fax_number": "540-536-5955",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "33820 Old Valley Pike Ste 2",
            "address_purpose": "LOCATION",
            "city": "Strasburg",
            "state": "VA",
            "postal_code": "226573793",
            "country_code": "US",
            "telephone_number": "540-459-1310",
            "fax_number": "540-459-1311",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1840 Amherst St",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226012808",
            "country_code": "US",
            "telephone_number": "540-536-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "415A South St",
            "address_purpose": "LOCATION",
            "city": "Front Royal",
            "state": "VA",
            "postal_code": "226302115",
            "country_code": "US",
            "telephone_number": "540-636-0495",
            "fax_number": "540-636-0450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "65 Riverton Commons Dr",
            "address_purpose": "LOCATION",
            "city": "Front Royal",
            "state": "VA",
            "postal_code": "226306768",
            "country_code": "US",
            "telephone_number": "540-635-0700",
            "fax_number": "540-635-8174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "607 E Jubal Early Dr",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226015178",
            "country_code": "US",
            "telephone_number": "540-536-2232",
            "fax_number": "540-536-2205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTTA",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-25",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0110003257",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbotta124183@soc.inova.org",
            "affiliation": "N",
            "address_1": "160 Merchant St Ste 200",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226034772",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbotta124183@soc.inova.org",
            "affiliation": "N",
            "address_1": "607 E Jubal Early Dr",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226015178",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbotta124183@soc.inova.org",
            "affiliation": "N",
            "address_1": "65 Riverton Commons Dr",
            "city": "Front Royal",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226306768",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbotta124183@soc.inova.org",
            "affiliation": "N",
            "address_1": "33820 Old Valley Pike Ste 2",
            "city": "Strasburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226573793",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbotta124183@soc.inova.org",
            "affiliation": "N",
            "address_1": "415A South St",
            "city": "Front Royal",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226302115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbotta124183@soc.inova.org",
            "affiliation": "N",
            "address_1": "1840 Amherst St",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226012808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Arsany Botros, DDS
• Emad M Botros, MD
• Mena Botros, DDS
• D. Gregory Bott, M.D.
• Jeffrey S Botta, DPT
• Timothy Bouck, MD
• T. Glen Bouder, MD
• Jessica Brunot Bouldin, CLC, CD
• Marissa Boutin
• Steven S Bowen

• Physician Assistant in Winchester, VA
• Providers in Winchester, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.