Kelly S Mueller

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9116874 Issued in FL

Practice address

8100 Sandpiper Cir Ste 308
Nottingham, MD 21236-4992

Phone

(410) 918-0777

NPI assigned

Dec 29, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL, MD, DC3 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 3

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent'S Ambulatory Care Inc 303 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent'S Southside Hospital, Jacksonville, FL, CCN 100307
• Ascension St Vincent'S Riverside Hospital, Jacksonville, FL, CCN 100040

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.mueller.1@8967.direct.athenahealth.com

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.

• St Vincents Ambulatory Care Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
  • NPI 1417987124

  FL

  Medicare reassignment Care Compare group NPD
• Doctors First, LLC

  • Internal Medicine Physician
  • Columbia, MD
  • NPI 1053077263

  MD

  Medicare reassignment NPD
• Doctors First, LLC

  • Internal Medicine Physician
  • Germantown, MD
  • NPI 1912160458

  DC

  Medicare reassignment

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

• St Lukes - St Vincents Healthcare

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1396926747

  Hospital

  Care Compare affiliation
• St Vincents Medical Center Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1134117575

  Hospital

  Care Compare affiliation
• St. Vincent'S Medical Center, Inc.

  • Clinical Medical Laboratory
  • Jacksonville, FL
  • NPI 1669556072

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1672272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1558074013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6699 GATE PKWY STE B",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322568079",
            "telephone_number": "904-450-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 SANDPIPER CIR STE 308",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212364992",
            "telephone_number": "410-918-0777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6699 Gate Pkwy Ste B",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322568079",
            "country_code": "US",
            "telephone_number": "904-450-8140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "KELLY",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-29",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0009203",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "687074100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND BOARD OF PHYSICIANS",
            "identifier": "C0009203",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Nottingham, MD
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; 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.