Kelli Elaine Fatheree, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA200105RX Issued in LA

Practice address

7460 Warren Pkwy
Suite 160
Frisco, TX 75034-4169

Phone

(972) 668-5400

NPI assigned

Jul 9, 2006

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 2

Medicare fee-for-service enrollment

Enrolled in TX

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.

• Healwell of Texas LLC

  • Physician Assistant
  • Austin, TX
  • NPI 1740976265
  Medicare reassignment
• Integrative Emergency Services Physician Group PA

  • Emergency Medicine Physician
  • Fort Worth, TX
  • NPI 1285922542
  Medicare reassignment
• Legacy Physiatry Group LLC

  • Physical Medicine & Rehabilitation Physician
  • Plano, TX
  • NPI 1316078769
  Medicare reassignment
• Mobile Wound Professionals LLC

  • Wound Care Registered Nurse
  • Austin, TX
  • NPI 1649092230
  Medicare reassignment
• Kirk Mitchell MD PA

  • Nurse Practitioner
  • Fort Worth, TX
  • NPI 1194522730
  NPD

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1225061435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7460 WARREN PKWY",
            "address_2": "SUITE 160",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75034",
            "telephone_number": "972-668-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7460 WARREN PKWY",
            "address_2": "SUITE 160",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750344169",
            "telephone_number": "972-668-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATHEREE",
        "first_name": "KELLI",
        "middle_name": "ELAINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA200105RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD PTAN",
            "identifier": "P01226202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1040312",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Veronica Bessey Farrar
• Kenya Ailisa Farris, LPC
• Shiann Fassitt
• Fastpass Ucc, PLLC
• Afrin Fatema, DMD
• Zainub Fatta
• Favorite Health Cooperation
• Favorite Home Health Care, LLC
• Faysal Y. Chaudhry DDS, PC
• Maria Fernanda D. Febres Aurich, RBT

• Physician Assistant in Frisco, TX
• Providers in Frisco, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; 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.