Kevin Joseph Kelly, MSN, APRN, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Rotan, TX
NPI 1376972943 · NPPES record last updated Oct 4, 2023
Key facts
- NPI
- 1376972943
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 717463 (TX)
- Practice address
- 774 State Highway 70 N
Rotan, TX 79546-6918 - Phone
- (325) 735-2256
- Fax
- (325) 735-3070
- NPI assigned
- Nov 5, 2013
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fisher County Hospital District
Practice addresses (Care Compare)
774 State Hwy 70 N
Rotan, TX 79546-6918
Phone (325) 735-2256
Hospital & facility affiliations
- Home Health of West Texas, LLC
- Fisher County Hospital District
- Rolling Plains Memorial Hospital
- Hendrick Medical Center
- Fisher County Hospital District
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140519000848 | TX | Practitioner - Nurse Practitioner | 7618190737 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 717463 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fisher County Hospital District | Current | Accepting new patients | |
| Fisher County Hospital District | Current |
Accepting new patients | |
| Fisher County Hospital District | Current | Accepting new patients | |
| Fisher County Hospital District | Current |
Accepting new patients |
Locations
774 State Highway 70 N
Rotan, TX 79546
Phone (325) 735-2256
Interoperability endpoints
- kevin.kelly.1@29392.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 717463 | TX | Yes |
Addresses
Primary practice location
774 State Highway 70 N
Rotan, TX 79546-6918
Mailing address
PO Drawer F
Rotan, TX 79546
Phone (325) 735-2256
Other providers in Rotan, TX
- Fisher County Hospital District
- Fisher County Hospital District
- Fisher County Hospital District
- Erin French
- Jackie Kelly
- Joseph Carver Lampley
- Celeste Morin
- Cleburne Lloyd Murdoch
- Melinda Powers
- Roby Rural Health Clinic
All providers in Rotan, TX · Family Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.