Individual provider Active NPI

Kellie K Yenrick, PA-C

  • Physician Assistant
  • Toledo, OH
National Provider Identifier
1538409396
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50003712 Issued in OH
Practice address
2940 N McCord Rd
Toledo, OH 43615-1753
Phone
(419) 842-3000
Fax
(419) 842-3042
NPI assigned
Feb 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 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 5601006693 MI
Physician Assistant 363A00000X 50003712 OH Primary

Addresses

Primary practice location

2940 N McCord Rd
Toledo, OH 43615-1753

Mailing address

2940 N McCord Rd
Toledo, OH 43615-1753
Phone (419) 842-3000

Other identifiers 1

IdentifierTypeStateIssuer
0080158MedicaidOH

Other names 1

  • Kellie K Schoenlein Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kyenrick12961@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 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
I20130320000644 OH Practitioner - Physician Assistant 3577708601 Reassigns benefits to 1 organization
I20130823001284 MI Practitioner - Physician Assistant 3577708601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Northwest Ohio Cardiology Consultants LLCGroup PAC ID 4981752938, 84 clinicians

Practice addresses (Care Compare)

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone (419) 291-4000

2940 N McCord Rd
Toledo, OH 43615-1753
Phone (419) 842-3000

Hospital & facility affiliations

  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
  • Promedica Charles and Virginia Hickman Hospital Hospital, Adrian, MI, CCN 230005
  • Memorial Hospital Hospital, Fremont, OH, CCN 360156
  • Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259
  • Promedica Defiance Regional Hospital Hospital, Defiance, OH, CCN 361328

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50003712OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Northwest Ohio Cardiology Consultants, LLC CurrentSince Feb 18, 2013 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

770 Riverside Ave
Ste 106
Adrian, MI 49221
Phone (517) 266-0525

1037 Conneaut Ave
Ste 202
Bowling Green, OH 43402
Phone (419) 354-0104

1600 E Riverview Ave
Napoleon, OH 43545
Phone (260) 344-3045

2751 Bay Park Dr
Ste 305
Oregon, OH 43616
Phone (419) 690-7689

615 Fulton St
Port Clinton, OH 43452
Phone (419) 734-3131

2940 N McCord Rd
Toledo, OH 43615
Phone (419) 842-3000

Interoperability endpoints

  • Direct secure messaging: kyenrick12961@direct.promedica.org

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 6

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": "1360886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1538409396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 N MCCORD RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151753",
            "telephone_number": "419-842-3000",
            "fax_number": "419-842-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 N MCCORD RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151753",
            "telephone_number": "419-842-3000",
            "fax_number": "419-842-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YENRICK",
        "first_name": "KELLIE",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-15",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006693",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50003712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0080158",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kyenrick12961@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "SCHOENLEIN",
            "middle_name": "K",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.