Individual provider Active NPI

Kelci Marie Hensley, PA-C

  • Physician Assistant
  • Adrian, MI
National Provider Identifier
1841655503
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007639 Issued in MI
Practice address
755 High St
Adrian, MI 49221-1442
Phone
(517) 265-2422
Fax
(517) 264-5926
NPI assigned
Dec 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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 5601007639 MI Primary

Addresses

Primary practice location

755 High St
Adrian, MI 49221-1442

Mailing address

1 Seagate Ste 800
Toledo, OH 43604-1558
Phone (517) 265-2422

Other identifiers 2

IdentifierTypeStateIssuer
M35150161OtherMIMEDICARE PIN
1841655503MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kschock30253@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160822000046 MI Practitioner - Physician Assistant 3678878196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Promedica Central Corporation of MichiganGroup PAC ID 7012902265, 112 clinicians

Practice addresses (Care Compare)

200 E Russell Rd
Unit C
Tecumseh, MI 49286-2072
Phone (517) 263-9491

781 Lakeshire TRL
Adrian, MI 49221-1561
Phone (517) 265-0600

Hospital & facility affiliations

  • Elara Caring Home health agency, Jackson, MI, CCN 237274
  • Promedica Charles and Virginia Hickman Hospital Hospital, Adrian, MI, CCN 230005

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Health Services, LTD Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: khensley30253@direct.promedica.org

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.

Hospital & facility affiliations 2

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": "1450828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1841655503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SEAGATE STE 800",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041558",
            "telephone_number": "517-265-2422",
            "fax_number": "517-264-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 HIGH ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211442",
            "telephone_number": "517-265-2422",
            "fax_number": "517-264-5926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSLEY",
        "first_name": "KELCI",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-23",
        "last_updated": "2023-11-03",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "M35150161",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841655503",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kschock30253@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Adrian, MI

Sources for this page

Verify at the official NPI Registry.