Kelly Michael Foley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2160 Issued in TN

Practice address

305 Dover Rd
Clarksville, TN 37042-4157

Phone

(931) 552-6722

Fax

(931) 552-6979

NPI assigned

Apr 24, 2007

Last updated

Dec 19, 2012By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

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.

• Gary W Cole

  • Family Medicine Physician
  • Clarksville, TN
  • NPI 1265689533
  NPD
• Kirksville Academic Medicine LLC

  • Internal Medicine Physician
  • Kirksville, MO
  • NPI 1396876355
  NPD (past)
• Kirksville Missouri Hospital Company LLC

  dba Family Health Center of Edina

  • Rural Health Clinic/Center
  • Edina, MO
  • NPI 1346215944
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1902025448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 DOVER RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370424157",
            "telephone_number": "931-552-6722",
            "fax_number": "931-552-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 DOVER RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370424157",
            "telephone_number": "931-552-6722",
            "fax_number": "931-552-6979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLEY",
        "first_name": "KELLY",
        "middle_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "2160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faith Floyd
• Brittney Fly
• Karen Andrea Flynn
• Focused ABA Services LLC
• Oluwatosin Elizabeth Folarin
• Bernie Folkerts, CRNA
• Milleena Fonseca, M.S., CF-SLP
• Morgan Sandmann Forbes, M.S., CCC-SLP
• Joshua Forbess, LCSW
• Brittany Brianna Forbus

• Physician Assistant in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; 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.