Kelan Lane Osborn

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2021038522 Issued in MO

Practice address

54 Hospital Dr Ste 102
Osage Beach, MO 65065-3050

Phone

(573) 348-8000

NPI assigned

Nov 17, 2014

Last updated

Aug 8, 2023By the provider in NPPES

Sex

Male

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

Medicare fee-for-service enrollment

Enrolled in OK, TX, MO3 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 3

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.

• Chickasaw Nation Division of Health

  dba Chickasaw Nation Medical Center

  • General Acute Care Hospital
  • Ada, OK
  • NPI 1255364923

  TX

  Medicare reassignment NPD
• Mercy Hospital Tishomingo, Inc

  • Emergency Medicine Physician
  • Tishomingo, OK
  • NPI 1972809002
  Medicare reassignment NPD
• Lake Regional Health System

  • Emergency Medical Services (Emergency Medicine) Physician
  • Osage Beach, MO
  • NPI 1053581454
  Medicare reassignment
• Mercy Clinic Oklahoma Communities

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1386874550
  Medicare reassignment
• Lake Regional Health System

  dba Lake Regional Orthopedics

  • Durable Medical Equipment & Medical Supplies
  • Lebanon, MO
  • NPI 1578125324
  NPD
• Lake Regional Health System

  • Internal Medicine Physician
  • Osage Beach, MO
  • NPI 1962828616
  NPD
• Chickasaw Nation Division of Health Chickasaw Nation Medical Center

  dba Minticha Apila

  • Home Health Agency
  • Ada, OK
  • NPI 1811739071
  NPD
• Mercy Hospital El Reno, Inc

  • Emergency Medicine Physician
  • El Reno, OK
  • NPI 1083910442
  NPD (past)

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

{
    "created_epoch": "1416182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1851797971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 HOSPITAL DR",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653050",
            "telephone_number": "573-348-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 HOSPITAL DR STE 102",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653050",
            "telephone_number": "573-348-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORN",
        "first_name": "KELAN",
        "middle_name": "LANE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-17",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "PA2441",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2021038522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220112004",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Osage Beach Center for Behavioral Health, LLC (Osage Beach Center for Behavioral Health)
• Osage Beach Family Eyecare Inc.
• Osage Eye Clinic PC
• Osage Family Clinic, LLC
• Osage Valley Plastic Surgery PC
• Carla Beth Ostronic, P.A.
• Ozark Rehabilitation & Health Care Center LLC
• Paige Hedgpath OD, PC (Eyes on Missouri)
• Nicole E. Parker, PSYD
• Larry L Parks

• Physician Assistant in Osage Beach, MO
• Providers in Osage Beach, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; 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.