Active NPI
Kelly Renee Sun, DO
- Internal Medicine Physician
- Crestview Hills, KY
National Provider Identifier
1417488222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- TP658
- Practice address
- 334 Thomas More Pkwy
Crestview Hills, KY 41017-3464 - Phone
- (593) 410-2888
- Fax
- (859) 341-7482
- NPI assigned
- Mar 23, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | TP658 | KY | Primary |
Addresses
Primary practice location
334 Thomas More Pkwy
Crestview Hills, KY 41017-3464
Mailing address
PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 344-5555
Other names 1
- Kelly Renee Biedenharn
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
334 Thomas More Pkwy
Crestview Hills, KY 41017-3464
Phone (859) 301-5901
580 Buttermilk Pike
Crescent Springs, KY 41017-1635
Phone (859) 341-6654
Hospital & facility affiliations
- St Elizabeth Home Care
- St Elizabeth Edgewood
- St Elizabeth Florence
- St Elizabeth Ft Thomas
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TP658 | KY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Group, Inc | Internal Medicine | Current | Accepting new patients |
| Summit Medical Group, Inc. | Current | Accepting new patients | |
| Summit Medical Group, Inc | Internal Medicine | Current | Accepting new patients |
Locations
334 Thomas More Pkwy
Crestview Hills, KY 41017
Phone (859) 331-6065
334 Thomas More Pkwy
Ste 200
Crestview Hills, KY 41017
Phone (859) 344-3737
1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700
300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217
Interoperability endpoints
- ksun335726@direct-prd.stelizabeth.com
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 and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Crescent Springs, KY
- NPI 1790780617
-
- Foot & Ankle Surgery Podiatrist
- Crestview Hills, KY
- NPI 1043188378
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Florence, KY
- NPI 1154365062
-
- General Acute Care Hospital
- Edgewood, KY
- NPI 1467492421
-
- General Acute Care Hospital
- Fort Thomas, KY
- NPI 1740221795
-
- Home Health Agency
- Florence, KY
- NPI 1316136534
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604880000000",
"number": "1417488222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 635283",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452635283",
"telephone_number": "859-344-5555",
"fax_number": "859-344-5552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "334 THOMAS MORE PKWY",
"city": "CRESTVIEW HILLS",
"state": "KY",
"postal_code": "410173464",
"telephone_number": "593-410-2888",
"fax_number": "859-341-7482"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUN",
"first_name": "KELLY",
"middle_name": "RENEE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-23",
"last_updated": "2020-11-09",
"certification_date": "2020-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "KY",
"license": "TP658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "BIEDENHARN",
"middle_name": "RENEE",
"credential": "DO",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Crestview Hills, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.