NPIMap

Individual provider Active NPI

Madelyn Reilly Kelly, APRN

  • Family Nurse Practitioner
  • Elizabethtown, KY
National Provider Identifier
1336900877
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4014307 Issued in KY
Practice address
2412 Ring Rd Ste 100
Elizabethtown, KY 42701-5912
Phone
(502) 629-5633
Fax
(502) 629-5580
NPI assigned
Jan 22, 2024
Last updated
Feb 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4014307 KY Primary

Addresses

Primary practice location

2412 Ring Rd Ste 100
Elizabethtown, KY 42701-5912

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other practice location 1

404 Nevis Dr
Elizabethtown, KY 42701-9155
Phone (270) 300-8705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20240419001284 KY Practitioner - Nurse Practitioner 6800235110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PT Pros, IncGroup PAC ID 0143139337, shared by 14 NPIs, 263 clinicians
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

201 S Main St
Leitchfield, KY 42754-1425
Phone (270) 230-1729

2412 Ring Rd
Suite 100
Elizabethtown, KY 42701-5912
Phone (270) 769-2273

4031 N Dixie Hwy
Suite 104
Elizabethtown, KY 42701-7873
Phone (270) 982-4776

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4014307KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Family Current Accepting new patients
Community Medical Associates, Inc. Family CurrentSince Mar 16, 2024 Accepting new patients
Community Medical Associates, Inc. CurrentSince Mar 16, 2024 Accepting new patients
Community Medical Associates, Inc. Past Accepting new patients

Locations

2412 Ring Rd
Ste 100
Elizabethtown, KY 42701
Phone (270) 737-2273

3 Audubon Plaza Dr
Ste 430
Louisville, KY 40217
Phone (502) 636-4900

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Interoperability endpoints

  • Direct secure messaging: mkelly283811@direct.nortonhealthcare.org

Organizations & group practices 4

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1336900877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 RING RD STE 100",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427015912",
            "telephone_number": "502-629-5633",
            "fax_number": "502-629-5580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "404 Nevis Dr",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "KY",
            "postal_code": "427019155",
            "country_code": "US",
            "telephone_number": "270-300-8705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MADELYN",
        "middle_name": "REILLY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-22",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4014307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

Verify at the official NPI Registry.