Kellie M Earle P.a., PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

3636 Issued in AZ

Practice address

4135 So. Power Rd
Suite 129
Mesa, AZ 85212

Phone

(480) 751-3091

Fax

(480) 751-3095

NPI assigned

Jul 23, 2007

Last updated

Apr 14, 2016By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Blair T Butterfield, PC

  dba Options Medical

  • Family Medicine Physician
  • Gilbert, AZ
  • NPI 1922031566
  NPD (past)

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460592000000",
    "number": "1891995296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1156 SO FERN CT",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85296",
            "telephone_number": "480-751-3091",
            "fax_number": "480-751-3095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 SO. POWER RD",
            "address_2": "SUITE 129",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85212",
            "telephone_number": "480-751-3091",
            "fax_number": "480-751-3095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARLE P.A.",
        "first_name": "KELLIE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2016-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "3636",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "010832",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eagle Eye Medical Transportation
• Eagles View Counseling and Family Services
• Jarod Eagles, D.C.
• Zachary Earhart, PHARMD
• Earl P. Duffy DDS PC
• Darcy Rae Easley
• East Mesa Dental Partners, LLP
• East Mesa Family Doctors PLLC
• East Mesa Medical Center (Dignity Health Arizona General Hospital Emergency Room)
• East Mesa Pediatrics, Inc

• Medical Physician Assistant in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.