Caryn Joy Axtell-Kelly, P.A.-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA17278 Issued in CA

Practice address

13193 Central Ave
Suite 220
Chino, CA 91710

Phone

(909) 591-0843

Fax

(909) 591-7226

NPI assigned

Jul 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

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Algos Inc., a Medical Corporation

  • Pain Medicine Physician
  • Pasadena, CA
  • NPI 1497747356
  Medicare reassignment NPD (past)
• Algos Inc., a Medical Corporation

  • Pain Medicine Physician
  • Visalia, CA
  • NPI 1245832419
  NPD
• Algos Inc., a Medical Corporation

  • Pain Medicine Physician
  • Rancho Mirage, CA
  • NPI 1336695675
  NPD
• Algos Inc., a Medical Corporation

  • Pain Medicine Physician
  • Simi Valley, CA
  • NPI 1063890275
  NPD (past)

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204848000000",
    "number": "1700815958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2492",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917292492",
            "telephone_number": "909-591-0843",
            "fax_number": "909-591-7226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13193 CENTRAL AVE",
            "address_2": "SUITE 220",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "91710",
            "telephone_number": "909-591-0843",
            "fax_number": "909-591-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AXTELL-KELLY",
        "first_name": "CARYN",
        "middle_name": "JOY",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-01",
        "last_updated": "2008-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA17278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA17278",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peter Attia, PHARMD, RPH
• Augustin a. Lin, D.O., Inc.
• Autism Behavior Centers Inc
• Avani Patel Shah MD Inc
• Jeshana E. Avent-Johnson, PSYD
• Seana Aylen, LCSW
• Anita Aynehchi, DO
• Ayouby and Bebing Dental Group
• B Joshi DDS Inc
• Bace Institute, LLC

• Medical Physician Assistant in Chino, CA
• Providers in Chino, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.