Pamela K Kelly, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1608 Issued in AZ

Practice address

1300 N 12TH St
Suite 520
Phoenix, AZ 85006-2848

Phone

(602) 495-4863

Fax

(602) 528-3120

NPI assigned

Apr 26, 2006

Last updated

Jun 22, 2016By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Atlas Medical Systems, PLLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1144730607
  NPD (past)

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1285691154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 12TH ST",
            "address_2": "SUITE 520",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062848",
            "telephone_number": "602-495-4863",
            "fax_number": "602-528-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "PAMELA",
        "middle_name": "K",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "1608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Lurline Kelly, ED.S.
• Luanne Takacs Kelly, NP
• Lynne Folger Kelly, OTR/L
• Megan Cathleen Kelly, MD
• Olivia Nicole Kelly
• Richard L Kelly, M.D.
• Robert Kelly, DC
• Sandra Lynne-Walker Kelly, RN
• Scott Michael Kelly, MS, ATC, LAT
• Shana Kelly

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.