Individual provider Active NPI

Kelsey Elizabeth Nolen, PA-C

  • Physician Assistant
  • Beverly, MA
National Provider Identifier
1770470460
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
83 Herrick St Ste 2004
Beverly, MA 01915-2757
Phone
(978) 927-4800
Fax
(978) 777-4792
NPI assigned
Jun 23, 2025
Last updated
Aug 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA Primary

Addresses

Primary practice location

83 Herrick St Ste 2004
Beverly, MA 01915-2757

Mailing address

83 Herrick St Ste 2004
Beverly, MA 01915-2757
Phone (978) 927-4800

Other practice location 1

204 Fawnwood St
St Johns, FL 32259-7419
Phone (774) 280-9234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Essex County OB/GYN Associates PastSince Aug 10, 2025 Accepting new patients
Essex County OBGYN Assoc Inc PastSince Aug 10, 2025 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1770470460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 HERRICK ST STE 2004",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019152757",
            "telephone_number": "978-927-4800",
            "fax_number": "978-777-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 HERRICK ST STE 2004",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019152757",
            "telephone_number": "978-927-4800",
            "fax_number": "978-777-4792"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 Fawnwood St",
            "address_purpose": "LOCATION",
            "city": "St Johns",
            "state": "FL",
            "postal_code": "322597419",
            "country_code": "US",
            "telephone_number": "774-280-9234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLEN",
        "first_name": "KELSEY",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.