Individual provider Active NPI

Kelly Denise Goins, PA-C

  • Physician Assistant
  • Hazard, KY
National Provider Identifier
1336659309
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2276 Issued in KY
Practice address
1908 N Main St Ste 120
Hazard, KY 41701-2503
Phone
(606) 439-2662
Fax
(606) 439-4738
NPI assigned
Oct 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2276 KY Primary
Physician Assistant 363A00000X

Addresses

Primary practice location

1908 N Main St Ste 120
Hazard, KY 41701-2503

Mailing address

PO Box 432
Pikeville, KY 41502-0432
Phone (606) 218-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20171025003515 KY Practitioner - Physician Assistant 7214203868 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2276KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Hospital LLC CurrentSince Mar 1, 2020 Accepting new patients
Kentucky Hospital, LLC Physician Assistant CurrentSince Mar 1, 2020 Accepting new patients
Primary Care Centers of Eastern Kentucky, LLC Current Accepting new patients
Primary Care Centers of Eastern Kentucky, LLC Current Accepting new patients
Primary Care Centers of Eastern Kentucky, LLC Current Accepting new patients
Primary Care Centers of Eastern Kentucky, LLC CurrentSince Nov 18, 2019 Accepting new patients
Primary Care Centers of Eastern Kentucky, LLC CurrentSince Nov 18, 2019 Accepting new patients

Locations

145 Citizens Ln
Ste B
Hazard, KY 41701
Phone (606) 439-1300

101 Town and Country Ln
#100
Hazard, KY 41701
Phone (606) 439-1300

425 Hindman Byp
Hindman, KY 41822
Phone (606) 785-1300

21992 Main St
Hyden, KY 41749
Phone (606) 672-5200

175 Hospital Dr
Winchester, KY 40391
Phone (859) 745-3500

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HCJFBA
  • Direct secure messaging: kelly.goins.p1@direct.kymha.nextgenshare.com

Organizations & group practices 9

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": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1336659309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 432",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415020432",
            "telephone_number": "606-218-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 N MAIN ST STE 120",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417012503",
            "telephone_number": "606-439-2662",
            "fax_number": "606-439-4738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOINS",
        "first_name": "KELLY",
        "middle_name": "DENISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-04",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2276",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazard, KY

Sources for this page

Verify at the official NPI Registry.