Staci W Kell, APRN
Individual provider Active NPI Family Nurse Practitioner · Benton, KY
NPI 1528084282 · NPPES record last updated Sep 3, 2024
Key facts
- NPI
- 1528084282
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 3004803 (KY)
- Practice address
- 83 Wellness Way Ste 101&201
Benton, KY 42025-7156 - Phone
- (270) 527-0045
- Fax
- (270) 527-9615
- NPI assigned
- Jul 14, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2006
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Mercy Health-Lourdes Hospital LLC
Practice addresses (Care Compare)
83 Wellness Way
Benton, KY 42025-7156
Hospital & facility affiliations
- Centerwell Home Health
- Marshall County Hospital Home Health
- Mercy Health - Lourdes Hospital
- Marshall County Hospital
- Baptist Health Paducah
- Murray-Calloway County Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070604000451 | KY | Practitioner - Nurse Practitioner | 2668570359 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health Physicians Kentucky LLC | Current |
Accepting new patients | |
| Mercy Health-Lourdes Hospital LLC | Current |
Accepting new patients | |
| Mercy Health-Lourdes Hospital LLC | Current |
Accepting new patients | |
| Mercy Health-Lourdes Hospital LLC | Current | Accepting new patients | |
| Mercy Health-Lourdes Hospital LLC | Past | Accepting new patients |
Locations
83 Wellness Way
Benton, KY 42025
Phone (270) 527-8601
83 Wellness Way
Ste 101201
Benton, KY 42025
Phone (270) 527-0045
83 Wellness Way
Ste 101
Benton, KY 42025
Phone (270) 527-0045
1532 Lone Oak Rd
Ste 245
Paducah, KY 42003
Phone (270) 538-5537
Interoperability endpoints
- skell111207@direct.bsmhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 3004803 | KY | |
| Family Nurse Practitioner | 363LF0000X | 3004803 | KY | Yes |
Addresses
Primary practice location
83 Wellness Way Ste 101&201
Benton, KY 42025-7156
Mailing address
83 Wellness Way Ste 101&201
Benton, KY 42025-7156
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 78017720 | Medicaid | KY |
Other names
- Staci W Fooshee
Other providers in Benton, KY
- Leigh Johnson
- Catherine N Jones
- Karen K Jones
- JW Pharmacy Inc
- Donita Keith
- Kentucky CVS Pharmacy, LLC
- Chloe Kerrick
- Kenneth B King
- Cady Knight
- Diane Kolenich
All providers in Benton, KY · Family Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.