Colleen R Kelly, P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

1500630 Issued in KS

Practice address

3651 College Blvd
Leawood, KS 66211-1910

Phone

(913) 319-7633

Fax

(913) 253-1764

NPI assigned

Jun 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Colleen R. Kelly-Perkins Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: colleen.kelly.1@33257.direct.athenahealth.com

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.

• American Current Care of Kansas PA

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1851797989
  NPD
• Midwest Trauma Services, LLC

  • Trauma Surgery Physician
  • Kansas City, MO
  • NPI 1063468361
  NPD (past)

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1245268754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12639 OLD TESSON RD",
            "address_2": "SUITE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282786",
            "telephone_number": "314-849-0311",
            "fax_number": "314-849-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 COLLEGE BLVD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111910",
            "telephone_number": "913-319-7633",
            "fax_number": "913-253-1764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "COLLEEN",
        "middle_name": "R",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": "119557",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KS",
            "license": "1500630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-KC",
            "identifier": "40122016",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckelly@kcoi.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3651 College Blvd",
            "city": "Leawood",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662111910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "KELLY-PERKINS",
            "middle_name": "R.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ashley Kearney, DPT
• Amy Keller
• Meredith Ashley Keller
• Michaela Marie Keller, DPT
• Alisha Kelly, APRN, FNP-C
• Shancy Kelly, LCP
• Tarrah Nicole Kelly, DPT
• Joseph Robert Kennedy, PHARMD
• Kelsey Kennedy, PHARMD
• Geoffrey Kerns, DDS

• Surgical Physician Assistant in Leawood, KS
• Providers in Leawood, KS by specialty
• Surgical Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.