Karlie Kellstrom, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110008566 Issued in VA

Practice address

7571 Cold Harbor Rd
Mechanicsville, VA 23111-1631

Phone

(703) 965-4325

NPI assigned

Apr 7, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA, DC2 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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Patient First Richmond Medical Group PLLCGroup PAC ID 9931011434, 315 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bon Secours Richmond Community Hospital Hospital, Richmond, VA, CCN 490094

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vaexchange@patientfirstclinics.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.

• Patient First Richmond Medical Group PLLC

  • Family Medicine Physician
  • Glen Allen, VA
  • NPI 1689603748

  DC

  Medicare reassignment Care Compare group NPD
• Patient First Richmond Medical Group PLLC

  • Urgent Care Clinic/Center
  • Fairfax, VA
  • NPI 1588018881
  NPD

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

• Bon Secours-Richmond Community Hospital LLC

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1366404428
  Care Compare affiliation

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1649912072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7571 COLD HARBOR RD",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231111631",
            "telephone_number": "804-746-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7571 COLD HARBOR RD",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231111631",
            "telephone_number": "703-965-4325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8110 Midlothian Tpke",
            "address_purpose": "LOCATION",
            "city": "North Chesterfield",
            "state": "VA",
            "postal_code": "232355116",
            "country_code": "US",
            "telephone_number": "804-320-8160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLSTROM",
        "first_name": "KARLIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-07",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "VAExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "8110 Midlothian Tpke",
            "city": "North Chesterfield",
            "state": "VA",
            "country_code": "US",
            "postal_code": "232355116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Annette Alyson Keffer, DPT
• Gerald E Keightley, M.D.
• Chloe Elaine Kellam, WHNP-BC
• Sallie Keller, LPTA
• Catherine Clancy Kellis, DC
• Kelly M. Chadwick, LCSW, LLC
• David L. Kelly, M.D.
• Leah Kemler, PA-C
• Guillaume Kengni
• Amanda Kennedy, LPT

• Physician Assistant in Mechanicsville, VA
• Providers in Mechanicsville, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.