Corie S Kelly, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3503 Issued in AZ

Practice address

525 S Watson Rd Ste 200
Buckeye, AZ 85326-3451

Phone

(602) 726-8750

Fax

(236) 474-5811

NPI assigned

Mar 29, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nextcare Arizona I JV LLCGroup PAC ID 7416393194, 297 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: corie.kellypac.p1@direct.nextcare.nextgenshare.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.

• Nextcare Arizona I JV LLC

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1114798071
  Medicare reassignment Care Compare group
• VHS Outpatient Clinics, Inc.

  • Multi-Specialty Clinic/Center
  • Goodyear, AZ
  • NPI 1912979964
  Medicare reassignment NPD
• Dispatchhealth-Arizona

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1922532944
  Medicare reassignment
• Nextcare Arizona LLC

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1043371826
  Medicare reassignment
• Dispatchhealth-Arizona

  • Emergency Medicine Physician
  • Columbia, MD
  • NPI 1811765449
  NPD
• Privia Medical Group Arizona, LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1760441141
  NPD (past)

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1598885170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 S WATSON RD STE 200",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853263451",
            "telephone_number": "602-726-8750",
            "fax_number": "236-474-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 S WATSON RD STE 200",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853263451",
            "telephone_number": "602-726-8750",
            "fax_number": "236-474-5811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1705 W University Dr Ste 104",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852813269",
            "country_code": "US",
            "telephone_number": "480-493-3444",
            "fax_number": "480-867-4464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CORIE",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Zelalem Kebede, PHARMD
• Taylor Hope Keel, MS
• Madison Christine Kelley, MA
• Tina Kemmer
• Kennedy Dentistry
• Jennifer Jo Kennedy, OTRL
• Matthew Kennedy, DDS
• Annette Kerr

• Physician Assistant in Buckeye, AZ
• Providers in Buckeye, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.
• 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.