Individual provider Active NPI

Kelli D. Brown, FNP-C

  • Nurse Practitioner
  • Owensboro, KY
National Provider Identifier
1790168516
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71005613A Issued in IN
Practice address
2816 Veach Rd Ste 403
Owensboro, KY 42303
Phone
(270) 684-1145
Fax
(270) 684-1190
NPI assigned
Jun 30, 2015
Last updated
Oct 3, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71005613A IN Primary
Family Nurse Practitioner 363LF0000X 3012493 KY
Family Nurse Practitioner 363LF0000X 28215502A IN

Addresses

Primary practice location

2816 Veach Rd Ste 403
Owensboro, KY 42303

Mailing address

PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 688-1330

Other practice location 1

4506 1st Ave
Evansville, IN 47710-3624
Phone (812) 428-6161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150807013736 IN Practitioner - Nurse Practitioner 8022322825 Reassigns benefits to 1 organization
I20181214001542 KY Practitioner - Nurse Practitioner 8022322825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perry County Memorial HospitalGroup PAC ID 6901871276, 28 clinicians

Practice addresses (Care Compare)

148 13TH St
Tell City, IN 47586-1937
Phone (812) 547-0333

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28215502AINMDFamily Nurse Practitioner
3012493KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic Inc Nurse Practitioner CurrentSince Nov 2, 2018 Accepting new patients
Perry County Memorial Hospital Nurse Practitioner CurrentSince Feb 1, 2024 Accepting new patients
Perry County Memorial Hospital Nurse Practitioner CurrentSince Feb 1, 2024 Accepting new patients
Deaconess Clinic, Inc Nurse Practitioner Current Accepting new patients
Perry County Memorial Hospital Family Past Accepting new patients
Advanced Wellness Chiropractic, PLLC PastSince Oct 1, 2022 Accepting new patients
Perry County Memorial Hospital Family Past Accepting new patients

Locations

109 US Highway 66 E
Tell City, IN 47586
Phone (812) 547-3447

148 13th St
Tell City, IN 47586
Phone (812) 547-0333

315 Main St
Troy, IN 47588
Phone (812) 547-9552

35 Joshua Ln
Hawesville, KY 42348
Phone (270) 927-1000

340 Starlite Dr
Henderson, KY 42420
Phone (270) 212-3070

1700 US Highway 60 W
Morganfield, KY 42437
Phone (270) 389-0031

Interoperability endpoints

  • Direct secure messaging: kelli.brown.1@21400.direct.athenahealth.com

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1790168516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-688-1330",
            "fax_number": "270-688-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2816 VEACH RD STE 403",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "42303",
            "telephone_number": "270-684-1145",
            "fax_number": "270-684-1190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4506 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477103624",
            "country_code": "US",
            "telephone_number": "812-428-6161",
            "fax_number": "812-421-2883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KELLI",
        "middle_name": "D.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-30",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71005613A",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3012493",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28215502A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.