Individual provider Active NPI

Kelsey Westerman Nolan, PA-C

  • Physician Assistant
  • Birmingham, AL
National Provider Identifier
1790024073
Registry record updated Jul 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
10 Old Montgomery Hwy
Suite 100
Birmingham, AL 35209-6737
Phone
(205) 949-1900
Fax
(205) 949-1919
NPI assigned
Feb 6, 2013
Last updated
Jul 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2017

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 Primary

Addresses

Primary practice location

10 Old Montgomery Hwy
Suite 100
Birmingham, AL 35209-6737

Mailing address

10 Old Montgomery Hwy
Suite 100
Birmingham, AL 35209-6737
Phone (205) 949-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20130717000073 AL Practitioner - Physician Assistant 7810137734 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
895ALMDClinical Psychologist

Organizations & group practices 1

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": "1360108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499212800000",
    "number": "1790024073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 OLD MONTGOMERY HWY",
            "address_2": "SUITE 100",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352096737",
            "telephone_number": "205-949-1900",
            "fax_number": "205-949-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 OLD MONTGOMERY HWY",
            "address_2": "SUITE 100",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352096737",
            "telephone_number": "205-949-1900",
            "fax_number": "205-949-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "KELSEY",
        "middle_name": "WESTERMAN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-06",
        "last_updated": "2017-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.