Individual provider Active NPI

Pamela Kelly

  • Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1922479344
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3009813 Issued in KY
Practice address
3 Audubon Plaza Drive Mob East
Suite 110
Louisville, KY 40217-1363
Phone
(502) 636-8266
Fax
(502) 636-8260
NPI assigned
Oct 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3009813 KY Primary

Addresses

Primary practice location

3 Audubon Plaza Drive Mob East
Suite 110
Louisville, KY 40217-1363

Mailing address

PO Box 950202
Louisville, KY 40295-0202
Phone (502) 588-9490

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20160217001057 KY Practitioner - Nurse Practitioner 2567767247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Nurse Practitioner CurrentSince Mar 1, 2016 Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner CurrentSince Mar 1, 2016 Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner Current Accepting new patients

Locations

3 Audubon Plaza Dr
Ste 110
Louisville, KY 40217
Phone (502) 367-8121

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Interoperability endpoints

  • Direct secure messaging: pkelly59762@direct.nortonhealthcare.org

Organizations & group practices 3

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": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1922479344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950202",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950202",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 AUDUBON PLAZA DRIVE MOB EAST",
            "address_2": "SUITE 110",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171363",
            "telephone_number": "502-636-8266",
            "fax_number": "502-636-8260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "PAMELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-12",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3009813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.