Individual provider Active NPI

Kayla Marie Kellams, MSN,FNP-C

  • Family Nurse Practitioner
  • Carlisle, IN
National Provider Identifier
1730813015
Registry record updated Aug 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F06221962 Issued in IN
Practice address
6908 S Old 41
Carlisle, IN 47838-8384
Phone
(812) 398-5050
NPI assigned
Jul 13, 2022
Last updated
Aug 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F06221962 IN Primary

Addresses

Primary practice location

6908 S Old 41
Carlisle, IN 47838-8384

Mailing address

PO Box 2
Carlisle, IN 47838-0002
Phone (812) 691-2579

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20221107000776 IN Practitioner - Nurse Practitioner 7315314200 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sullivan County Community HospitalGroup PAC ID 2466497482, shared by 5 NPIs, 44 clinicians

Practice addresses (Care Compare)

1005 S 3Rd St
Dugger Medical Clinic
Dugger, IN 47848-5011
Phone (812) 648-0228

2200 N Section St
Sullivan, IN 47882-7523
Phone (812) 268-4311

2229 Mary Sherman Dr
Sullivan, IN 47882-7633
Phone (812) 268-3318

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F06221962INMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sullivan County Community Hospital CurrentSince Nov 7, 2022 Accepting new patients
Sullivan County Community Hospital CurrentSince Nov 7, 2022 Accepting new patients
Sullivan County Community Hospital CurrentSince Nov 7, 2022 Accepting new patients
Sullivan Family Practice, LLC Current Accepting new patients

Locations

2186 N Hospital Blvd
Ste 2
Sullivan, IN 47882
Phone (812) 268-3318

2200 N Section St
Sullivan, IN 47882
Phone (812) 268-6292

2200 N Section St
Ste A
Sullivan, IN 47882
Phone (812) 268-6292

2229 Mary Sherman Dr
Sullivan, IN 47882
Phone (812) 238-2100

Interoperability endpoints

  • Direct secure messaging: kayla.kellams.6@8793.direct.athenahealth.com

Organizations & group practices 5

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 3

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": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661040000000",
    "number": "1730813015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2",
            "city": "CARLISLE",
            "state": "IN",
            "postal_code": "478380002",
            "telephone_number": "812-691-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6908 S OLD 41",
            "city": "CARLISLE",
            "state": "IN",
            "postal_code": "478388384",
            "telephone_number": "812-398-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLAMS",
        "first_name": "KAYLA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSN,FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-13",
        "last_updated": "2022-08-21",
        "certification_date": "2022-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "F06221962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlisle, IN

Sources for this page

Verify at the official NPI Registry.