Kaylie Nicole Prichodko, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10001876A Issued in IN

Practice address

1629 Medical Arts Blvd Ste 200
Anderson, IN 46011-3454

Phone

(765) 298-5439

Fax

(765) 298-4920

NPI assigned

Apr 24, 2015

Last updated

Jul 20, 2026By 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 2

Addresses

Other identifiers 1

Other names 1

• Kaylie Nicole Waltz Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kprichodko717349@direct.ochin.org

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.

• Community Physicians of Indiana Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1619105244
  Medicare reassignment NPD
• Jane Pauley Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Indianapolis, IN
  • NPI 1730488818
  Medicare reassignment
• Community Physicians of Indiana Inc

  dba Community Physician Network

  • Endocrinology, Diabetes & Metabolism Physician
  • Carmel, IN
  • NPI 1992396337
  NPD
• St Vincent Pediatric Subspecialties

  • Pediatrics Physician
  • Indianapolis, IN
  • NPI 1013967736
  NPD (past)

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1851788178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12816",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154019",
            "telephone_number": "317-338-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 MEDICAL ARTS BLVD STE 200",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460113454",
            "telephone_number": "765-298-5439",
            "fax_number": "765-298-4920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 E Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112991",
            "country_code": "US",
            "telephone_number": "317-373-1741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8333 Naab Rd Ste 320",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462601983",
            "country_code": "US",
            "telephone_number": "317-338-3000",
            "fax_number": "317-338-5057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRICHODKO",
        "first_name": "KAYLIE",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-24",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006233",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001876A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PTAN",
            "identifier": "P01512454",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kprichodko@luriechildrens.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "225 E Chicago Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606112991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KAYLIE",
            "last_name": "WALTZ",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Preferred Family Physicians
• Pregnancy Plus Clinic
• Premise Health of Indiana Medical PC (Caesars Health Center Hoosier Park Anderson)
• Prevail Prosthetics and Orthotics
• Meghan Price, FNP
• Progressive Radiation Oncology, PC
• Trevor Pruitt
• Briana Simone Pryor
• Leslie Renee Pryor, RDH
• Psychiatric Help and Hope LLC

• Physician Assistant in Anderson, IN
• Providers in Anderson, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.