Kelly Frances Canterberry, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3013140 Issued in KY

Practice address

343 E Center St
Madisonville, KY 42431-2135

Phone

(270) 452-2420

Fax

(270) 452-2438

NPI assigned

Feb 14, 2019

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

Other names 1

• Kelly Frances Flach Former name

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

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.

• Fast Pace Kentucky PLLC

  • Family Nurse Practitioner
  • Franklin, KY
  • NPI 1457716706

  Family, KY

  Medicare reassignment NPD
• Hometown Care LLC

  • Family Nurse Practitioner
  • Dixon, KY
  • NPI 1417395815

  Family

  NPD
• Fast Pace Kentucky, PLLC

  • Rural Health Clinic/Center
  • Spindale, NC
  • NPI 1942027891
  NPD

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1770049751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 BILL DORRIS RD",
            "city": "CLAY",
            "state": "KY",
            "postal_code": "424049507",
            "telephone_number": "941-224-5526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 E CENTER ST",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424312135",
            "telephone_number": "270-452-2420",
            "fax_number": "270-452-2438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTERBERRY",
        "first_name": "KELLY",
        "middle_name": "FRANCES",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-14",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3013140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "FLACH",
            "middle_name": "FRANCES",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kara Burrow, COTA/L
• Misty Burton, OTR/L
• Jamie Lynn Byars, PHARMD
• Corina Byford, PHARMD
• Jason Aaron Canterberry, PA-C
• Brianna Shaunte Capel, RN, CEBP, MAED.
• Cardiology Consultants, PSC
• Caris Counseling & Behavioral Health Group
• Jason Matthew Carl, MA, ATC, CSCS
• Carol McCraw DMD Ms PSC

• All providers in Madisonville, KY
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.