Jaan Kelly, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1072 Issued in TN

Practice address

9330 Park West Blvd
Suite 202
Knoxville, TN 37923-4308

Phone

(865) 691-4850

Fax

(865) 694-8018

NPI assigned

Oct 26, 2005

Last updated

Dec 9, 2010By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Medicine West PLLCGroup PAC ID 7618126608, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Family Medicine West PLLC

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1083962815
  Medicare reassignment Care Compare group
• Covenant Medical Group, Inc.

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1457302010
  Medicare reassignment NPD
• Saint Thomas Medical Partners

  dba Ascension Medical Group Saint Thomas

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1437194669
  Medicare reassignment NPD
• Covenant Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
  • NPI 1871269415
  NPD
• Family Medicine West PLLC

  dba Family Medicine West of Wartburg

  • Rural Health Clinic/Center
  • Wartburg, TN
  • NPI 1902292865
  NPD
• Cardiovascular Specialist , P.C.

  • Vascular Surgery Physician
  • Memphis, TN
  • NPI 1730142795
  NPD (past)
• Knoxville Mindful Wellness Center, LLC

  • Clinical Social Worker
  • Knoxville, TN
  • NPI 1902375942
  NPD (past)
• Specialty Physician Group LLC

  • Cardiovascular Disease Physician
  • Germantown, TN
  • NPI 1174842181

  Medical

  NPD (past)

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291852800000",
    "number": "1831189190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9330 PARK WEST BLVD",
            "address_2": "SUITE 202",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234308",
            "telephone_number": "865-691-4850",
            "fax_number": "865-694-8018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9330 PARK WEST BLVD",
            "address_2": "SUITE 202",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234308",
            "telephone_number": "865-691-4850",
            "fax_number": "865-694-8018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JAAN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2010-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "1072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Laurel Ann Kelly, FNP
• Dana Elizabeth Kelly
• Donna June Kelly
• Elizabeth Rowan Kelly, MD
• Erin Kelly
• Lauren Elizabeth Kelly, PT
• Melanie W. Kelly, FNP
• Michael Edward Kelly, M.D.
• Paul Kelly, LMT
• Stacey Christine Kelly, OTA

• Medical Physician Assistant in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Medical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.