Courtney G Kelm, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2515 Issued in AZ

Practice address

725 S Dobson Rd
Ste 100
Chandler, AZ 85224-5680

Phone

(602) 795-8700

Fax

(602) 795-8701

NPI assigned

Feb 1, 2006

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

Other identifiers 1

Other names 1

• Courtney G McDaniel Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 1, 2019 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Arizona Spine and Pain Specialists LLC

  • Interventional Pain Medicine Physician
  • Glendale, AZ
  • NPI 1336552140
  NPD (past)
• Arthrocare Arthritis Care and Research, P.C.

  • Rheumatology Physician
  • Gilbert, AZ
  • NPI 1447351879
  NPD (past)
• Center for Neurology and Stroke PLC

  • Neurology Physician
  • Phoenix, AZ
  • NPI 1508891581
  NPD (past)

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450224000000",
    "number": "1619948064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20280 N 59TH AVE",
            "address_2": "STE 115-617",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086850",
            "telephone_number": "602-795-8700",
            "fax_number": "602-795-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S DOBSON RD",
            "address_2": "STE 100",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245680",
            "telephone_number": "602-795-8700",
            "fax_number": "602-795-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELM",
        "first_name": "COURTNEY",
        "middle_name": "G",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-01",
        "last_updated": "2015-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "2515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "623307",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "MCDANIEL",
            "middle_name": "G",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mackenzie Kelley
• Christopher M Kellogg, MD
• David Norris Kells, M.D.
• Kailey R Kelly, PA
• Melanie Mercedes Kelly, PA-C
• Sandra Kay Kelman, WHNP-BC-NP
• Ella Kelsay
• Melissa Kelsey, D.O.
• Heather Kelso
• Benjamin C Kelto, DPT

• Medical Physician Assistant in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.