Individual provider Active NPI

Kelly Cello, PA-C

  • Physician Assistant
  • Leawood, KS
National Provider Identifier
1497219398
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15-02349 Issued in KS
Practice address
3651 College Blvd
Leawood, KS 66211-1910
Phone
(913) 319-7600
Fax
(913) 253-1702
NPI assigned
Jan 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2020025180 MO
Physician Assistant 363A00000X 15-02349 KS Primary

Addresses

Primary practice location

3651 College Blvd
Leawood, KS 66211-1910

Mailing address

3651 College Blvd
Leawood, KS 66211-1910
Phone (913) 319-7600

Other names 1

  • Kelly Godbey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200828001763 KS Practitioner - Physician Assistant 2062839558 Reassigns benefits to 1 organization
I20200831001937 MO Practitioner - Physician Assistant 2062839558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Missouri, Kansas City, School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Dickson Diveley Midwest Orthopaedic Clinic LLCGroup PAC ID 1153225479, 66 clinicians

Practice addresses (Care Compare)

100 E Kansas St
Lansing, KS 66043-1610
Phone (913) 758-0283

3651 College Blvd
Leawood, KS 66211-1910
Phone (913) 319-7600

4320 Wornall Rd
Suite 610
Kansas City, MO 64111-3235
Phone (913) 319-7600

7450 Kessler St
Suite 140
Merriam, KS 66204-2550
Phone (913) 319-7600

Hospital & facility affiliations

  • Kansas City Orthopaedic Institute Hospital, Leawood, KS, CCN 170188
  • St Lukes Hospital of Kansas City Hospital, Kansas City, MO, CCN 260138

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15-02349KSMDPhysician Assistant
2020025180MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dickson Diveley Midwest Orthopaedic Clinic LLC CurrentSince Jul 1, 2020 Accepting new patients
Dickson Diveley Midwest Orthopaedic Clinic LLC CurrentSince Jul 1, 2020 Accepting new patients
Main Line Healthcare Past Accepting new patients

Locations

3651 College Blvd
Ste 100B
Leawood, KS 66211
Phone (913) 362-0031

10777 Nall Ave
Ste 300
Overland Park, KS 66211
Phone (913) 257-6259

3651 W 111th St
Overland Park, KS 66211
Phone (800) 876-5958

7450 Kessler St
Ste 140
Shawnee Mission, KS 66204
Phone (913) 319-7600

17067 S Outer Rd
Ste 301
Belton, MO 64012
Phone (913) 257-6259

201 W Road Mize Rd
Ste 200
Blue Springs, MO 64014
Phone (913) 319-7600

4320 Wornall Rd
Ste 610
Kansas City, MO 64111
Phone (913) 319-7600

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1497219398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3651 COLLEGE BLVD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111910",
            "telephone_number": "913-319-7600",
            "fax_number": "913-253-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 COLLEGE BLVD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111910",
            "telephone_number": "913-319-7600",
            "fax_number": "913-253-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CELLO",
        "first_name": "KELLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-24",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2020025180",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-02349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "GODBEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Leawood, KS

Sources for this page

Verify at the official NPI Registry.