Individual provider Active NPI

Erin Grey Kelly, PA-C

  • Surgical Physician Assistant
  • Washington, DC
National Provider Identifier
1225767015
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA200001812 Issued in DC
Practice address
900 23Rd St NW
Washington, DC 20037-2342
Phone
(202) 715-4000
NPI assigned
Jun 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OH
Surgical Physician Assistant 363AS0400X PA200001812 DC Primary

Addresses

Primary practice location

900 23Rd St NW
Washington, DC 20037-2342

Mailing address

3533 Southern Blvd Ste 2100
Kettering, OH 45429-1267
Phone (937) 395-8556

Other practice location 1

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 298-4331

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ekelly751587@direct.ketteringhealth.org
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230207002171 OH Practitioner - Physician Assistant 1254703911 Reassigns benefits to 2 organizations
I20241014001678 DC Practitioner - Physician Assistant 1254703911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Faculty Associates, IncGroup PAC ID 4082528898, 676 clinicians

Practice addresses (Care Compare)

900 23Rd St NW
Washington, DC 20037-2342
Phone (202) 715-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physicians Inc CurrentSince Sep 26, 2022 Accepting new patients
Alliance Physicians, Inc. CurrentSince Sep 26, 2022 Accepting new patients
Beavercreek Medical Center Past Accepting new patients

Locations

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

3533 Southern Blvd
Ste 2100
Kettering, OH 45429
Phone (937) 293-3486

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1225767015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3533 SOUTHERN BLVD STE 2100",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291267",
            "telephone_number": "937-395-8556",
            "fax_number": "937-395-6376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 23RD ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200372342",
            "telephone_number": "202-715-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291221",
            "country_code": "US",
            "telephone_number": "937-298-4331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ERIN",
        "middle_name": "GREY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "DC",
            "license": "PA200001812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ekelly751587@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3535 Southern Blvd",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291221",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "3535 Southern Blvd",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.