Mary Catherine Kehl, PA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3035 Issued in AZ

Practice address

410 N Malacate St
Ajo, AZ 85321-2254

Phone

(520) 387-5651

Fax

(520) 387-6036

NPI assigned

Oct 19, 2006

Last updated

Dec 27, 2019By 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 2

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dispatchhealth-Arizona

  dba DispatchHealth

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1922532944
  Medicare reassignment
• Northwest HBP Medical Services LLC

  • Emergency Medicine Physician
  • Tucson, AZ
  • NPI 1407353006
  Medicare reassignment
• Progressive Medical Associates PLLC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1548218613
  Medicare reassignment
• Innova Emergency Medical Associates PC

  • Emergency Medicine Physician
  • Trinidad, CO
  • NPI 1295178978

  AZ

  Medicare reassignment
• Dispatchhealth-Arizona

  • Emergency Medicine Physician
  • Columbia, MD
  • NPI 1811765449
  NPD
• Lutheran Hospital Association of the San Luis Valley

  dba San Luis Valley Health Regional Medical Center

  • General Acute Care Hospital
  • Alamosa, CO
  • NPI 1235181744
  NPD
• True North Health Navigation LLC

  dba Dispatch Health

  • Emergency Medicine Physician
  • Denver, CO
  • NPI 1740622133
  NPD
• Swea, P.C.

  dba Southwest Emergency Associates, P.C.

  • Emergency Medicine Physician
  • Tucson, AZ
  • NPI 1407953573
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1225110224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N MALACATE ST",
            "city": "AJO",
            "state": "AZ",
            "postal_code": "853212254",
            "telephone_number": "520-387-5651",
            "fax_number": "520-387-6036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N MALACATE ST",
            "city": "AJO",
            "state": "AZ",
            "postal_code": "853212254",
            "telephone_number": "520-387-5651",
            "fax_number": "520-387-6036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1705 W University Dr Ste 104",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852813269",
            "country_code": "US",
            "telephone_number": "480-493-3444",
            "fax_number": "480-867-4464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEHL",
        "first_name": "MARY",
        "middle_name": "CATHERINE",
        "name_prefix": "Ms.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890518-02",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "890518",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gorky Herrera, M.D.
• Thomas Eugene Horst, MD
• Donald T Innes, P.A.
• Carol A Johnson, D.O.
• Brian David Jones, MPT
• Jeffrey R Lavoy, M.D.
• Lifetorch Recovery Center & Wellness LLC
• Lifetorch Recovery Center & Wellness LLC
• Jennifer K Lim, DDS
• Michael Mason

• Physician Assistant in Ajo, AZ
• Providers in Ajo, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; 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.