Kelsey Burnett, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2382 Issued in OK

Practice address

1009 W Ferguson Ave
Blackwell, OK 74631-5602

Phone

(580) 363-0052

NPI assigned

Mar 13, 2014

Last updated

Mar 13, 2014By 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

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

AMC Urgent Care Plus LLCGroup PAC ID 3971509381, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Integris Health Ponca City Hospital, Ponca City, OK, CCN 370006

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kelsey.burnett.1@31440.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• AMC Urgent Care Plus, LLC

  • General Practice Physician
  • Ponca City, OK
  • NPI 1285644153
  Medicare reassignment Care Compare group
• Triad Complete Healthcare A06 LLC

  • Primary Care Clinic/Center
  • Stillwater, OK
  • NPI 1932809738
  NPD (past)

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

• Integris Health Ponca City Hospital Inc

  dba Integris Health Ponca City Hospital

  • General Acute Care Hospital
  • Ponca City, OK
  • NPI 1548047616
  Care Compare affiliation

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

{
    "created_epoch": "1394668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1275959314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 W FERGUSON AVE",
            "city": "BLACKWELL",
            "state": "OK",
            "postal_code": "746315602",
            "telephone_number": "580-363-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 W FERGUSON AVE",
            "city": "BLACKWELL",
            "state": "OK",
            "postal_code": "746315602",
            "telephone_number": "580-363-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "KELSEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-13",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blackwell Vision Center Inc
• Jeffrey S Blanton, DC
• Paul A. Briggs, M.D.
• Rebecca Marcelle Bristow, D.C.
• Samuel David Bryner, DMD
• Nita L Calvin, PA
• Joby V Chambers, REGISTERED NURSE
• Michelle Chan, DDS
• Amanda Kay Childers, BSN RN
• City of Blackwell (Blackwell Fire Department Ambulance)

• Physician Assistant in Blackwell, OK
• Providers in Blackwell, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.