Kelsey Locken, PA-C, RT(R)

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA61454774 Issued in WA

Practice address

2925 Ryan Dr SE
Salem, OR 97301-9687

Phone

(503) 399-1262

NPI assigned

Feb 26, 2020

Last updated

Jun 28, 2024By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Enrolled in OR, WA2 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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Radia Inc P SGroup PAC ID 9931012812, 275 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050
• Peacehealth St John Medical Center Hospital, Longview, WA, CCN 500041
• Legacy Salmon Creek Medical Center Hospital, Vancouver, WA, CCN 500150

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Radia Inc P S

  dba Radia

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1932196607
  Medicare reassignment Care Compare group NPD
• Salem Clinic, PC

  • General Practice Physician
  • Salem, OR
  • NPI 1912935594
  Medicare reassignment NPD
• Legacy Salmon Creek Hospital

  dba Legacy Salmon Creek Providers

  • Clinic/Center
  • Vancouver, WA
  • NPI 1356357784
  Medicare reassignment NPD
• Legacy Salmon Creek Hospital

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1700809829
  NPD
• Salem Imaging LLC

  • Diagnostic Radiology Physician
  • Salem, OR
  • NPI 1114978418
  NPD (past)

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

• Legacy Salmon Creek Hospital

  dba Legacy Salmon Creek Providers

  • Clinic/Center
  • Vancouver, WA
  • NPI 1356357784

  Hospital

  Care Compare affiliation
• Legacy Salmon Creek Hospital

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1700809829
  Care Compare affiliation
• Peacehealth

  dba PeaceHealth SW Heart & Vascular Center

  • Cardiovascular Disease Physician
  • Vancouver, WA
  • NPI 1003194911

  Hospital

  Care Compare affiliation
• Peacehealth

  dba St. John Medical Center

  • General Acute Care Hospital
  • Longview, WA
  • NPI 1073510277
  Care Compare affiliation
• Peacehealth

  dba PeaceHealth Southwest Medical Center

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999
  Care Compare affiliation

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1679107841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 RYAN DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973019687",
            "telephone_number": "503-399-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 RYAN DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973019687",
            "telephone_number": "503-399-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKEN",
        "first_name": "KELSEY",
        "credential": "PA-C, RT(R)",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-26",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61454774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON STATE LICENSE",
            "identifier": "PA201560",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roxanne K. Livingston, M.A
• Lladro Massage and Bodywork
• Edgar A Llamas
• Dinah Loa, M.D.
• Heather Loch, RD, LD
• Toni Lynn Locker, MSW, LCSW
• Lacey Beth Lockhart
• Locklab Provider Group, LLC
• Jeffrey Lockwood, RN/CRNA
• Holly Loescher, HAS-P, COHC

• Physician Assistant in Salem, OR
• Providers in Salem, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.