Individual provider Active NPI

Kelsey Welborn, PA-C

  • Physician Assistant
  • Sevierville, TN
National Provider Identifier
1649955725
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5514 Issued in TN
Practice address
1787 Veterans Blvd
Sevierville, TN 37862-6945
Phone
(865) 428-2773
NPI assigned
Jun 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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 4801 SC
Physician Assistant 363A00000X 5514 TN Primary

Addresses

Primary practice location

1787 Veterans Blvd
Sevierville, TN 37862-6945

Mailing address

1787 Veterans Blvd
Sevierville, TN 37862-6945
Phone (865) 428-2773

Other practice location 1

3322 N Main St
Anderson, SC 29621-4108
Phone (864) 715-3309

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, SC2 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
I20231010000715 TN Practitioner - Physician Assistant 8527413608 Reassigns benefits to 1 organization
I20240530001812 SC Practitioner - Physician Assistant 8527413608 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Urgent Care of South Carolina PCGroup PAC ID 1254703788, 158 clinicians

Practice addresses (Care Compare)

1305 S Suber Rd
Greer, SC 29650-0944
Phone (864) 989-4609

1615 Sandifer Blvd
Seneca, SC 29678-0905
Phone (864) 920-7910

3322 N Main St
Anderson, SC 29621-4108
Phone (864) 715-3309

6043 Calhoun Memorial Hwy
Easley, SC 29640-3811
Phone (803) 794-6780

Merit-based Incentive Payment System (MIPS)

Final score
83.98 of 100Reported as group
Quality
73.31
Promoting interoperability
100
Improvement activities
40
Cost
73.29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4801SCMDPharmacist
5514TNMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chuc, LLC Physician Assistant PastSince Jun 18, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kwelborn763950@direct.ghs.myhfn.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.

NPI Registry JSON

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

{
    "created_epoch": "1686873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1649955725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1787 VETERANS BLVD",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378626945",
            "telephone_number": "865-428-2773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1787 VETERANS BLVD",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378626945",
            "telephone_number": "865-428-2773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3322 N Main St",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "SC",
            "postal_code": "296214108",
            "country_code": "US",
            "telephone_number": "864-715-3309",
            "fax_number": "864-715-3312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELBORN",
        "first_name": "KELSEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-16",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4801",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sevierville, TN

Sources for this page

Verify at the official NPI Registry.