Kelsey Elyse Etley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA08636 Issued in TX

Practice address

3142 Horizon Rd Ste 110
Rockwall, TX 75032-7810

Phone

(972) 771-1171

Fax

(972) 771-1173

NPI assigned

Jul 31, 2013

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

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 and National Provider Directory roles.

• Texas Health Back Care

  dba Spine Team Texas

  • Physical Medicine & Rehabilitation Physician
  • Southlake, TX
  • NPI 1770952830
  NPD
• Texas Health Physicians Group

  dba Sleep Healers

  • Sleep Disorder Diagnostic Clinic/Center
  • Dallas, TX
  • NPI 1174992051
  NPD
• Texas Health Physicians Group

  • Internal Medicine Physician
  • Kaufman, TX
  • NPI 1992151740
  NPD

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1730511882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3142 HORIZON RD STE 110",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750327810",
            "telephone_number": "972-771-1171",
            "fax_number": "972-771-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3142 HORIZON RD STE 110",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750327810",
            "telephone_number": "972-771-1171",
            "fax_number": "972-771-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETLEY",
        "first_name": "KELSEY",
        "middle_name": "ELYSE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-31",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stt@116.direct.myezyaccess.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3142 Horizon Rd Ste 110",
            "city": "Rockwall",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750327810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sally Escuin, FNP-C
• Nicole Eshom, L.C.M.
• Ruthie Espinosa, M.S. CCC-SLP
• Casey Espinoza, OTR
• Lucas James Etheridge, DPT
• Eva B Kozlovsky Ms PC (Rockwall Speech Language Services)
• Danielle Evans, LPC ASSOCIATE
• Ronald Glenn Evans, D.D.S.
• Eventalist (Plested Senior Solutions)
• Evolution Healthcare Services Inc.

• Physician Assistant in Rockwall, TX
• Providers in Rockwall, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.