Individual provider Active NPI

Erika W Kelly, DO

  • Internal Medicine Physician
  • Russell Springs, KY
National Provider Identifier
1679934558
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
04297 Issued in KY
Practice address
404 Steve Drive
Russell Springs, KY 42642-4622
Phone
(270) 866-3161
Fax
(270) 866-3163
NPI assigned
Mar 18, 2016
Last updated
Jul 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 04297 KY Primary

Addresses

Primary practice location

404 Steve Drive
Russell Springs, KY 42642-4622

Mailing address

PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 858-6655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181228000983 KY Practitioner - Internal Medicine 2264777960 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lincoln Memorial University Medical Department, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apogee Medical Group Kentucky PSCGroup PAC ID 8820164411, 30 clinicians

Practice addresses (Care Compare)

305 Langdon St
Somerset, KY 42503-2750
Phone (606) 451-2994

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Kentucky, PSC Internal Medicine CurrentSince Dec 5, 2020 Accepting new patients
Cumberland Family Medical Center Inc CurrentSince Jun 14, 2022 Accepting new patients
Cumberland Family Medical Center Inc Current Accepting new patients
Apogee Medical Group, Kentucky, PSC CurrentSince Nov 18, 2018 Accepting new patients
Cumberland Family Medical Center Inc CurrentSince Jun 14, 2022 Accepting new patients
Lake Cumberland Regional Hospital LLC Past Accepting new patients

Locations

360 Keen St
Burkesville, KY 42717
Phone (270) 864-1472

150 N Eagle Creek Dr
Lexington, KY 40509
Phone (859) 267-9773

1001 Saint Joseph Ln
London, KY 40741
Phone (606) 330-6000

404 Steve Dr
Russell Springs, KY 42642
Phone (270) 866-3161

305 Langdon St
Somerset, KY 42503
Phone (606) 451-2994

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1679934558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-858-6655",
            "fax_number": "270-858-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 STEVE DRIVE",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "426424622",
            "telephone_number": "270-866-3161",
            "fax_number": "270-866-3163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ERIKA",
        "middle_name": "W",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "04297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Russell Springs, KY

Sources for this page

Verify at the official NPI Registry.