Kelly Ann Lueders, DMS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-443 Issued in AR

Practice address

2110 W Walnut St
Rogers, AR 72756-3246

Phone

(479) 202-7035

NPI assigned

May 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• Kelly Ann Elliott Former name

Medicare fee-for-service enrollment

Enrolled in AR, MO2 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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Access Medical Clinic Arkansas LLC 143 clinicians

SHC Medical Partners of Arkansas LLC 28 clinicians

Appello Health and Wellness Clinic LLC 76 clinicians

Curana Health of Arkansas LLC 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.lueders.1@15024.direct.athenahealth.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.

• SHC Medical Partners of Arkansas, LLC

  • Nurse Practitioner
  • Little Rock, AR
  • NPI 1821830795

  AR

  Medicare reassignment Care Compare group NPD
• Appello Health and Wellness Clinic, LLC

  • Rural Health Clinic/Center
  • Malvern, AR
  • NPI 1215773262

  AR

  Medicare reassignment Care Compare group
• Curana Health of Arkansas LLC

  • Nurse Practitioner
  • Bentonville, AR
  • NPI 1659750214

  AR

  Medicare reassignment Care Compare group
• Abode Care Partners Al VB, LLC

  • Nurse Practitioner
  • Little Rock, AR
  • NPI 1861205460

  AR

  Medicare reassignment NPD
• Abode Care Partners LTC VB, LLC

  • Nurse Practitioner
  • Little Rock, AR
  • NPI 1669285367

  AR

  Medicare reassignment NPD
• Icp Arkansas Aco Billing LLC

  • Clinical Nurse Specialist
  • Maumelle, AR
  • NPI 1679157838

  AR

  Medicare reassignment NPD
• Access Medical Clinic Arkansas LLC

  • Rural Health Clinic/Center
  • Salem, AR
  • NPI 1578007647

  AR

  Medicare reassignment
• Medical Associates of Northwest Arkansas, PA

  • Internal Medicine Physician
  • Fayetteville, AR
  • NPI 1801847827

  AR

  Medicare reassignment
• Mercy Northwest Arkansas Ambulatory Services LLC

  • Urgent Care Clinic/Center
  • Springdale, AR
  • NPI 1366922320

  AR

  Medicare reassignment
• Northwest Benton County Physician Services LLC

  • Family Medicine Physician
  • Bentonville, AR
  • NPI 1871553073

  AR

  Medicare reassignment
• Northwest Physicians LLC

  • Obstetrics Physician
  • Springdale, AR
  • NPI 1194768721

  AR

  Medicare reassignment
• Pea Ridge Urgent Care Clinic

  • Urgent Care Clinic/Center
  • Pea Ridge, AR
  • NPI 1558140749

  AR

  Medicare reassignment

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1730135922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 W WALNUT ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727563246",
            "telephone_number": "479-202-7035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 W WALNUT ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727563246",
            "telephone_number": "479-202-7035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2103 Slack St",
            "address_purpose": "LOCATION",
            "city": "Pea Ridge",
            "state": "AR",
            "postal_code": "727514005",
            "country_code": "US",
            "telephone_number": "479-765-1980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUEDERS",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "DMS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1191",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AR",
            "license": "PA-443",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-443",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": "2009009834",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100768880I",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100768880J",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BC/BS",
            "identifier": "5V349",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "ELLIOTT",
            "middle_name": "ANN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• LS Counseling
• LTC of Rogers, LLC
• Scott Allen Ludwig, CRNA
• Lisa Luebker, RPH
• Andrew J Lueders, MD
• Luke a Jamison DDS
• Holly Ann Lungren, LAC
• Rebecca S Luther, APRN
• Daniel Luttrell, LPC, LAMFT
• Luxottica of America Inc

• All providers in Rogers, AR
• Physician Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.