Individual provider Active NPI

Kelsey Anne Vogler, PA-C

  • Physician Assistant
  • Amarillo, TX
National Provider Identifier
1780197327
Registry record updated Apr 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA11658 Issued in TX
Practice address
3501 S Soncy Rd Ste 150
Amarillo, TX 79119-6426
Phone
(806) 212-6353
Fax
(806) 212-0558
NPI assigned
Nov 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2018

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 PA11658 TX Primary

Addresses

Primary practice location

3501 S Soncy Rd Ste 150
Amarillo, TX 79119-6426

Mailing address

PO Box 840026
Dallas, TX 75284-0026
Phone (806) 212-6965

Other names 1

  • Kelsey Anne Dickson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20171128002490 TX Practitioner - Physician Assistant 2062779184 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA11658TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bsa Physicians Group Inc CurrentSince Nov 15, 2017 Accepting new patients

Locations

1751 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2129

3501 S Soncy Rd
Ste 150
Amarillo, TX 79119
Phone (806) 212-6353

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523318400000",
    "number": "1780197327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840026",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840026",
            "telephone_number": "806-212-6965",
            "fax_number": "806-212-6278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 S SONCY RD STE 150",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791196426",
            "telephone_number": "806-212-6353",
            "fax_number": "806-212-0558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOGLER",
        "first_name": "KELSEY",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-06",
        "last_updated": "2018-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "DICKSON",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.