Individual provider Active NPI

Kylie Laughery

  • Medical Physician Assistant
  • Butler, PA
National Provider Identifier
1841769213
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA059994 Issued in PA
Practice address
250B Butler CMNS
Butler, PA 16001-2485
Phone
(877) 987-4368
NPI assigned
Nov 15, 2018
Last updated
Jun 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA059994 PA Primary

Addresses

Primary practice location

250B Butler CMNS
Butler, PA 16001-2485

Mailing address

206 Lemmon Hollow Rd
Kittanning, PA 16201-3322

Other practice location 1

8702 University Blvd
Moon Township, PA 15108-4209
Phone (412) 299-3627

Other identifiers 1

IdentifierTypeStateIssuer
MA059994MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, PA2 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
I20200124000594 OH Practitioner - Physician Assistant 0345675195 Reassigns benefits to 3 organizations
I20200310001555 PA Practitioner - Physician Assistant 0345675195 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA059994PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medexpress Urgent Care, PC - Pennsylvania Single Specialty CurrentSince Jan 1, 2024 Accepting new patients
Medexpress Urgent Care, PC - Pennsylvania Single Specialty CurrentSince Jan 1, 2024 Accepting new patients

Locations

4808 Edgmont Ave
Brookhaven, PA 19015
Phone (610) 876-3072

8702 University Blvd
Moon Twp, PA 15108
Phone (412) 299-3627

7219 McKnight Rd
Ste F
Pittsburgh, PA 15237
Phone (412) 367-3278

Interoperability endpoints

  • Direct secure messaging: klaughery20826@gohealthupmc.direct-ci.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.

NPI Registry JSON

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1841769213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 LEMMON HOLLOW RD",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162013322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250B BUTLER CMNS",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160012485",
            "telephone_number": "877-987-4368"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8702 University Blvd",
            "address_purpose": "LOCATION",
            "city": "Moon Township",
            "state": "PA",
            "postal_code": "151084209",
            "country_code": "US",
            "telephone_number": "412-299-3627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAUGHERY",
        "first_name": "KYLIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA059994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MA059994",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Butler, PA

Sources for this page

Verify at the official NPI Registry.