Kelly Kay Green, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

AT006307 Issued in PA

Practice address

937 Park Ave
Meadville, PA 16335-3334

Phone

(814) 724-6211

NPI assigned

Aug 20, 2013

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 Kay Lytle Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• R. W. Petruso Hearing and Audiology Center, Inc

  • Hearing Aid Equipment
  • Meadville, PA
  • NPI 1619010733
  NPD (past)

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1780017145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 PARK AVE",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163353334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 PARK AVE",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163353334",
            "telephone_number": "814-724-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KELLY",
        "middle_name": "KAY",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-20",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT006307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "LYTLE",
            "middle_name": "KAY",
            "credential": "AUD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Goss Eye Care, LLC (Crawford Eye Associates)
• Sara Goss, O.D.
• Leanna Gosser, PA-C
• Stephanie JL Graham, RN
• Green Prosthetics & Orthotics LLC
• Greenfield Counseling Services Inc
• Gregory a. Griffith, OD
• Melissa Grenn-Fuller
• Gagandeep Singh Grewal
• Matthew Griffith, OD

• Audiologist in Meadville, PA
• Providers in Meadville, PA by specialty
• Audiologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.