Active NPI
Shivali Kanal, PA-C
- Physician Assistant
- Lexington, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA3464
- Practice address
- 1720 Nicholasville Rd Ste 500
Lexington, KY 40503-1487 - Phone
- (859) 278-1114
- Fax
- (859) 277-0541
- NPI assigned
- Sep 28, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA3464 | KY | Primary |
| Physician Assistant | 363A00000X | 085009409 | IL |
Addresses
Primary practice location
1720 Nicholasville Rd Ste 500
Lexington, KY 40503-1487
Mailing address
1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-6200
Other practice location 1
230 Fountain Ct Ste 230
Lexington, KY 40509-1897
Phone (859) 977-5335
Other practice location 2
1012 Ival James Blvd Ste B
Richmond, KY 40475-8278
Phone (859) 624-3615
Other practice location 3
200 Bevins Ln Ste A
Georgetown, KY 40324-8532
Phone (502) 863-9007
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7101021470 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201102000129 | TN | Practitioner - Physician Assistant | 5294145322 | Reassigns benefits to 1 organization |
| I20241025003577 | KY | Practitioner - Physician Assistant | 5294145322 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- New Lexington Clinic PSCH2 Rehabilitation Services of Kentucky, LLC
Practice addresses (Care Compare)
1012 Ival James Blvd B
Richmond, KY 40475-8174
Phone (859) 624-3615
1207 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-4000
1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-4000
1225 S Broadway
Suite 201
Lexington, KY 40504-2701
Phone (859) 258-4568
193 Glades Rd
Berea, KY 40403-2261
Phone (859) 956-1055
230 Fountain CT
Suite 230
Lexington, KY 40509-1897
Phone (859) 977-5335
Hospital & facility affiliations
- Baptist Health Lexington
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA3464 | KY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Humphreys County Community Health Services Inc | Current | Accepting new patients | |
| Humphreys County Community Health Services, Inc. | Current | Accepting new patients | |
| New Lexington Clinic, PSC | Current | Accepting new patients | |
| New Lexington Clinic PSC | Current | Accepting new patients |
Locations
200 Bevins Ln
Ste A
Georgetown, KY 40324
Phone (502) 863-0722
1720 Nicholasville Rd
Ste 500
Lexington, KY 40503
Phone (859) 278-1114
1221 S Broadway
Lexington, KY 40504
Phone (859) 258-4181
230 Fountain Ct
Ste 230
Lexington, KY 40509
Phone (859) 977-5335
1012 Ival James Blvd
Ste B
Richmond, KY 40475
Phone (859) 624-3615
451 Highway 13 S
Waverly, TN 37185
Phone (931) 296-0211
Interoperability endpoints
- shivali.kanal.1@13059.direct.athenahealth.com
- skanal@advent.emadirect.md
Organizations & group practices 14
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.
-
- Critical Access Hospital
- Waverly, TN
- NPI 1235387044
TN
-
- Rehabilitation Clinic/Center
- Berea, KY
- NPI 1205192721
-
- Rehabilitation Clinic/Center
- Richmond, KY
- NPI 1457304123
-
- Rehabilitation Clinic/Center
- Alexandria, KY
- NPI 1730131632
-
- Rehabilitation Clinic/Center
- Glasgow, KY
- NPI 1740232404
-
- Rehabilitation Clinic/Center
- Murray, KY
- NPI 1881647527
-
- Rehabilitation Clinic/Center
- London, KY
- NPI 1881649507
-
- Rehabilitation Clinic/Center
- Horse Cave, KY
- NPI 1891748562
-
- Ambulatory Surgical Clinic/Center
- Lexington, KY
- NPI 1093595696
-
- Clinical Medical Laboratory
- Lexington, KY
- NPI 1144321951
-
- Ambulatory Surgical Clinic/Center
- Lexington, KY
- NPI 1881789964
Hospital & facility affiliations 1
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": "1601251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734048000000",
"number": "1861009482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1221 S BROADWAY",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405042701",
"telephone_number": "859-258-6200",
"fax_number": "859-258-6203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1720 NICHOLASVILLE RD STE 500",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405031487",
"telephone_number": "859-278-1114",
"fax_number": "859-277-0541"
}
],
"practiceLocations": [
{
"address_1": "230 Fountain Ct Ste 230",
"address_purpose": "LOCATION",
"city": "Lexington",
"state": "KY",
"postal_code": "405091897",
"country_code": "US",
"telephone_number": "859-977-5335",
"fax_number": "859-977-5340",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1012 Ival James Blvd Ste B",
"address_purpose": "LOCATION",
"city": "Richmond",
"state": "KY",
"postal_code": "404758278",
"country_code": "US",
"telephone_number": "859-624-3615",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "200 Bevins Ln Ste A",
"address_purpose": "LOCATION",
"city": "Georgetown",
"state": "KY",
"postal_code": "403248532",
"country_code": "US",
"telephone_number": "502-863-9007",
"fax_number": "502-863-9008",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KANAL",
"first_name": "SHIVALI",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-28",
"last_updated": "2024-12-13",
"certification_date": "2024-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KY",
"license": "PA3464",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085009409",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7101021470",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.