Individual provider Active NPI

Kelley Yandell, P.A.-C, R.D.

  • Medical Physician Assistant
  • Nashville, TN
National Provider Identifier
1427463538
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2528 Issued in TN
Practice address
28 White Bridge Rd
Ste. 300
Nashville, TN 37205-1499
Phone
(615) 356-4111
Fax
(615) 356-8011
NPI assigned
Jun 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Renal Nutrition Registered Dietitian 133VN1005X 0739 TN
Medical Physician Assistant 363AM0700X 2528 TN Primary

Addresses

Primary practice location

28 White Bridge Rd
Ste. 300
Nashville, TN 37205-1499

Mailing address

28 White Bridge Rd
Ste. 300
Nashville, TN 37205-1499
Phone (615) 356-4111

Other identifiers 1

IdentifierTypeStateIssuer
Q010216MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20141030002550 TN Practitioner - Physician Assistant 9830310036

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1407 W Baddour Pkwy
Lebanon, TN 37087-2513

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0739TNMDRenal Nutrition Registered Dietitian
2528TNMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1427463538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 WHITE BRIDGE RD",
            "address_2": "STE. 300",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372051499",
            "telephone_number": "615-356-4111",
            "fax_number": "615-356-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 WHITE BRIDGE RD",
            "address_2": "STE. 300",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372051499",
            "telephone_number": "615-356-4111",
            "fax_number": "615-356-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANDELL",
        "first_name": "KELLEY",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C, R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "TN",
            "license": "0739",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "2528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q010216",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.