Individual provider Active NPI

Kimberly Joyce Kelly, AU.D.

  • Specialist
  • Lititz, PA
National Provider Identifier
1861453052
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
AT055864 Issued in PA
Practice address
100 Highlands Dr
Suite 201
Lititz, PA 17543-7693
Phone
(717) 627-4327
Fax
(717) 627-2690
NPI assigned
Mar 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X AT055864 PA Primary

Addresses

Primary practice location

100 Highlands Dr
Suite 201
Lititz, PA 17543-7693

Mailing address

325 Carol Lynn Dr
Willow Street, PA 17584-9364
Phone (717) 464-2144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041008000676 PA Practitioner - Qualified Audiologist 9638138159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lancaster Ear Nose and Throat LLCGroup PAC ID 1557527017, 4 clinicians

Practice addresses (Care Compare)

930 Red Nose CT
Suite 301
Lancaster, PA 17601-1981
Phone (717) 517-9083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AT055864PAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Deaf and Hard of Hearing Services of Lancaster County Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1861453052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 CAROL LYNN DR",
            "city": "WILLOW STREET",
            "state": "PA",
            "postal_code": "175849364",
            "telephone_number": "717-464-2144",
            "fax_number": "717-464-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGHLANDS DR",
            "address_2": "SUITE 201",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175437693",
            "telephone_number": "717-627-4327",
            "fax_number": "717-627-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KIMBERLY",
        "middle_name": "JOYCE",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "AT055864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lititz, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.