NPIMap

Individual provider Active NPI

Sloane Kelly, PA

  • Physician Assistant
  • Bedford, VA
National Provider Identifier
1306683420
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110010373 Issued in VA
Practice address
1613 Oakwood St Ste 201
Bedford, VA 24523-1213
Phone
(540) 586-7273
NPI assigned
Jul 15, 2024
Last updated
Sep 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110010373 VA Primary

Addresses

Primary practice location

1613 Oakwood St Ste 201
Bedford, VA 24523-1213

Mailing address

18 W Princeton Cir Apt 113
Lynchburg, VA 24503-1471

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241104000064 VA Practitioner - Physician Assistant 8224561915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians

Practice addresses (Care Compare)

1613 Oakwood St
Bedford, VA 24523-1213

1901 Tate Springs Rd
Lynchburg, VA 24501-1109
Phone (434) 947-3033

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110010373VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Health Professional Services, LLC CurrentSince Oct 1, 2024 Accepting new patients

Locations

140 Vista Centre Dr
Fl 2
Forest, VA 24551
Phone (434) 200-2297

Organizations & group practices 2

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1306683420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 W PRINCETON CIR APT 113",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245031471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 OAKWOOD ST STE 201",
            "city": "BEDFORD",
            "state": "VA",
            "postal_code": "245231213",
            "telephone_number": "540-586-7273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SLOANE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110010373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, VA

Sources for this page

Verify at the official NPI Registry.