Kelby Lynn Withrow, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2022009903 Issued in MO

Practice address

13861 Manchester Rd
Ballwin, MO 63011-4503

Phone

(636) 556-0114

NPI assigned

Feb 7, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Total Access Urgent Care PCGroup PAC ID 8820171929, 130 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

42.87 of 100Reported as group

Quality

31.86

Promoting interoperability

0

Improvement activities

40

Cost

61.04

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.

• Total Access Urgent Care, PC

  • Urgent Care Clinic/Center
  • Saint Louis, MO
  • NPI 1962684886
  Medicare reassignment Care Compare group NPD
• Total Access Urgent Care, PC

  • Urgent Care Clinic/Center
  • Saint Louis, MO
  • NPI 1952729402
  NPD

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

{
    "created_epoch": "1549497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1770048308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4603 MATTIS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283015",
            "telephone_number": "618-316-8321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13861 MANCHESTER RD",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114503",
            "telephone_number": "636-556-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHROW",
        "first_name": "KELBY",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-07",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2022009903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Lyn Willis, RPH
• Jessica Elizabeth Willmann, PLPC
• Brandi Nicole Wilson, PLPC
• Kyle Winters
• Leah Winzen, R.D.
• Wonderfully Made Pediatrics
• Shawn Kurt Woodard, D.C.
• Deanna Wright-Coffman, LCSW
• Melissa Wright, PLPC
• Carol A. Yeager, M.A.

• Physician Assistant in Ballwin, MO
• Providers in Ballwin, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.