Active NPI
Kelly C Prikkel, PAC
- Physician Assistant
- Troy, OH
National Provider Identifier
1386697225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50001110
- Practice address
- 3130 N Dixie Hwy
Troy, OH 45373-1337 - Phone
- (937) 440-4600
- Fax
- (937) 339-4056
- NPI assigned
- May 19, 2006
- Last updated
- Jun 17, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 50001110 | OH | Primary |
Addresses
Primary practice location
3130 N Dixie Hwy
Troy, OH 45373-1337
Mailing address
4750 Hempstead Station Dr
Kettering, OH 45429-5164
Phone (800) 875-0136
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50001110 | OH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sidney Emergency Physicians, Inc. | Past | Accepting new patients | |
| West Central Emergency Physicians | Past | Accepting new patients |
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.
-
- Emergency Medicine Physician
- Sidney, OH
- NPI 1467690149
-
- Emergency Medicine Physician
- Troy, OH
- NPI 1578558417
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371427200000",
"number": "1386697225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4750 HEMPSTEAD STATION DR",
"city": "KETTERING",
"state": "OH",
"postal_code": "454295164",
"telephone_number": "800-875-0136",
"fax_number": "937-619-4231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3130 N DIXIE HWY",
"city": "TROY",
"state": "OH",
"postal_code": "453731337",
"telephone_number": "937-440-4600",
"fax_number": "937-339-4056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIKKEL",
"first_name": "KELLY",
"middle_name": "C",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-19",
"last_updated": "2013-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50001110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, OH
- Kiara Pooler
- Aruna K Prattipati, MD
- Premier Community Health (UVMC Occupational Health)
- Premier Health Pharmacy-Uvmc
- Premier Health Specialists Inc (The Cardiovascular Institute)
- Primary Care Internists, Inc.
- Primary Eyecare Associates Inc
- Michelle L Prior, LSW
- Procare of Troy LLC (ProCare Vision Center)
- Max Alexander Pulfer, APRN-CNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.