Individual provider Active NPI

Katelin Pacella

  • Student in an Organized Health Care Education/Training Program
  • Jonesboro, AR
National Provider Identifier
1295587665
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
333B Red Wolf Blvd
Jonesboro, AR 72405-9739
Phone
(870) 972-2054
NPI assigned
Apr 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

333B Red Wolf Blvd
Jonesboro, AR 72405-9739

Mailing address

PO Box 119
State University, AR 72467-0119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250521000458 OH Order and Referring Only - Physical Medicine and RehabilitationPractitioner - Physical Medicine and Rehabilitation 9931627122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New York Institute of Technology CurrentSince Apr 9, 2024 Accepting new patients

Locations

333 Red Wolf Blvd
#B
Jonesboro, AR 72405
Phone (870) 680-8809

Interoperability endpoints

  • Direct secure messaging: kpacella646596@ehrdirect.uhhospitals.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1295587665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 119",
            "city": "STATE UNIVERSITY",
            "state": "AR",
            "postal_code": "724670119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333B RED WOLF BLVD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724059739",
            "telephone_number": "870-972-2054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACELLA",
        "first_name": "KATELIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.