Kelly Marie Krause, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-567 Issued in AR

Practice address

2062 Highway 62 W
Mountain Home, AR 72653-7656

Phone

(870) 425-5464

Fax

(870) 425-5465

NPI assigned

Aug 11, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Kelly M Jank Former name

Medicare fee-for-service enrollment

Enrolled in AR

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mark S King, MD, PAGroup PAC ID 5294888780, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Mark S King, MD, PA

  • Dermatology Physician
  • Mountain Home, AR
  • NPI 1619107398
  Medicare reassignment Care Compare group
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1487063897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 763",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "72654",
            "telephone_number": "870-425-5464",
            "fax_number": "870-425-5465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2062 HIGHWAY 62 W",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726537656",
            "telephone_number": "870-425-5464",
            "fax_number": "870-425-5465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUSE",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-11",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-567",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AR",
            "license": "PA-567",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "JANK",
            "middle_name": "M",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Akihiro Kobayashi, M.B.
• Samantha Koch
• Christopher Kohler
• Mary Jane Korson, LICENSED PROFESSIONA
• Ryan Thomas Krafft, D.O.
• Kristy Dawson Counseling Services
• Kimberly Eve Kroeze, PT, DPT
• Carmel C Kruse, FNPBC
• Hayley Erin Lackey
• Michelle Lacriola

• Physician Assistant in Mountain Home, AR
• Providers in Mountain Home, AR by specialty
• Physician Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.

Verify at the official NPI Registry.