Samantha Jayne Kelly, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2023027198 Issued in MO

Practice address

302 US-65
Lincoln, MO 65338-2012

Phone

(660) 547-3915

NPI assigned

Jul 7, 2023

Last updated

Jul 7, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bothwell Regional Health CenterGroup PAC ID 6103714126, 109 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Benton County Health Department Home Health Agency Home health agency, Warsaw, MO, CCN 267223
• Bothwell Regional Health Center Hospital, Sedalia, MO, CCN 260009

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bothwell Regional Health Center

  • General Acute Care Hospital
  • Sedalia, MO
  • NPI 1235102690
  Medicare reassignment Care Compare group NPD
• Bothwell Regional Health Center

  dba Cole Camp Clinic

  • Rural Health Clinic/Center
  • Cole Camp, MO
  • NPI 1497705313
  NPD
• Bothwell Regional Health Center

  dba Bothwell Physicians Group

  • General Practice Physician
  • Sedalia, MO
  • NPI 1508239781
  NPD

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

• Benton Co Public Health

  • Home Health Agency
  • Warsaw, MO
  • NPI 1568443778
  Care Compare affiliation
• Bothwell Regional Health Center

  • General Acute Care Hospital
  • Sedalia, MO
  • NPI 1235102690
  Care Compare affiliation
• Bothwell Regional Health Center

  dba Cole Camp Clinic

  • Rural Health Clinic/Center
  • Cole Camp, MO
  • NPI 1497705313

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1740968080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31963 HWY AD",
            "city": "COLE CAMP",
            "state": "MO",
            "postal_code": "653252823",
            "telephone_number": "660-281-1006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 US-65",
            "city": "LINCOLN",
            "state": "MO",
            "postal_code": "653382012",
            "telephone_number": "660-547-3915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SAMANTHA",
        "middle_name": "JAYNE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-07-07",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2023027198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bristol Care, Inc.
• County of Benton School District R 2
• Lindsey Christine Decker, DC
• Haley Jordan Evans
• Kristin Greene
• Lyndsey Koll
• Lincoln Community Nursing Home
• Lincoln Family Medicine P.C.
• April Ream

• Family Nurse Practitioner in Lincoln, MO
• Providers in Lincoln, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.