Kailey Diann Vernon, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

363AM0700X Issued in IN

Practice address

7165 Clearvista Way
Indianapolis, IN 46256-4621

Phone

(317) 621-5100

NPI assigned

Jul 10, 2020

Last updated

Nov 4, 2020By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Community Physicians of Indiana Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1619105244
  Medicare reassignment NPD
• Lafayette Emergency Physicians, Inc

  dba Boone County Emergency Medicine

  • Emergency Medicine Physician
  • Lebanon, IN
  • NPI 1891741641
  Medicare reassignment
• Community Physicians of Indiana Inc

  dba Community Physician Network

  • Endocrinology, Diabetes & Metabolism Physician
  • Carmel, IN
  • NPI 1992396337
  NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1497373963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7165 CLEARVISTA WAY",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462564621",
            "telephone_number": "317-621-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5750 Brockton Ct Apt 6",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462205467",
            "country_code": "US",
            "telephone_number": "317-313-5875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERNON",
        "first_name": "KAILEY",
        "middle_name": "DIANN",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-10",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "363AM0700X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ranu Verma, DO
• Katelyn Vermilyer
• Michael Frederick Vermilyer, CMT, MMP
• Dominic James Vernon, MD
• Hamilton Vernon, DO
• Tyler Lee Vernon, DO
• Veronica Vernon, PHARMD
• Michael C Veronesi, MD
• Dezarae Verrett
• Morgan E Verrill, MS, LCGC

• Medical Physician Assistant in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Medical Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.