Individual provider Active NPI

Kelsey Purcell, PA-C

  • Medical Physician Assistant
  • Winchester, TN
National Provider Identifier
1235585001
Registry record updated May 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3010 Issued in TN
Practice address
185 Hospital Rd
Winchester, TN 37398-2404
Phone
(931) 967-8200
Fax
(931) 967-8205
NPI assigned
May 10, 2016
Last updated
May 10, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3010 TN Primary

Addresses

Primary practice location

185 Hospital Rd
Winchester, TN 37398-2404

Mailing address

110 Toccoas TRL
Christiana, TN 37037-1415
Phone (419) 360-2555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20160727000560 TN Practitioner - Physician Assistant 1557654621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amg-Southern Tennessee LLCGroup PAC ID 5991765943, 54 clinicians

Practice addresses (Care Compare)

2006 Decherd Blvd
Decherd, TN 37324-3818
Phone (931) 967-0931

2008 Decherd Blvd
Decherd, TN 37324-3818
Phone (931) 967-0931

81 Memorial Dr
Winchester, TN 37398-2401
Phone (931) 967-0450

83 Memorial Dr
Winchester, TN 37398-2401
Phone (931) 967-3966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3010TNMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Amg-Southern Tennessee LLC CurrentSince May 15, 2017 Accepting new patients
Amg-Southern Tennessee LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kelsey.purcell.1@19363.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462838400000",
    "number": "1235585001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 TOCCOAS TRL",
            "city": "CHRISTIANA",
            "state": "TN",
            "postal_code": "370371415",
            "telephone_number": "419-360-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 HOSPITAL RD",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373982404",
            "telephone_number": "931-967-8200",
            "fax_number": "931-967-8205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURCELL",
        "first_name": "KELSEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-10",
        "last_updated": "2016-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "3010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, TN

Sources for this page

Verify at the official NPI Registry.