NPIMap

Individual provider Active NPI

Kelsey R Jansen, PA-C

  • Physician Assistant
  • Jasper, IN
National Provider Identifier
1942645577
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001694A Issued in IN
Practice address
1900 Saint Charles St
Jasper, IN 47546-9145
Phone
(812) 634-1211
Fax
(812) 634-9762
NPI assigned
May 9, 2013
Last updated
May 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10001694A IN Primary
Surgical Physician Assistant 363AS0400X 50003807 OH

Addresses

Primary practice location

1900 Saint Charles St
Jasper, IN 47546-9145

Mailing address

1900 Saint Charles St
Jasper, IN 47546-9145
Phone (812) 634-1211

Other identifiers 1

IdentifierTypeStateIssuer
0090771MedicaidOH

Other names 1

  • Kelsey R Vonderheide Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140815001837 IN Practitioner - Physician Assistant 1254575749 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Norris and Love Orthopaedic and Sports PCGroup PAC ID 4981695228, 12 clinicians

Practice addresses (Care Compare)

1900 Saint Charles St
Jasper, IN 47546-9145
Phone (812) 634-1211

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10001694AINMDPhysician Assistant
50003807OHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Specialty Physicians, Inc Physician Assistant Current Accepting new patients
Saint Charles Surgical Pavilion Inc Current Accepting new patients
Deaconess Speciality Physicians, Inc Physician Assistant CurrentSince Oct 16, 2025 Accepting new patients
Deaconess Specialty Physicians Inc Physician Assistant CurrentSince Oct 16, 2025 Accepting new patients
Saint Charles Surgical Pavilion Inc Current Accepting new patients

Locations

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

1900 Saint Charles St
Jasper, IN 47546
Phone (812) 634-1211

Interoperability endpoints

  • Direct secure messaging: kjansen1051815@direct.deaconess.com

Organizations & group practices 7

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.

Hospital & facility affiliations 4

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": "1368057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1942645577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SAINT CHARLES ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475469145",
            "telephone_number": "812-634-1211",
            "fax_number": "812-634-9762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SAINT CHARLES ST",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475469145",
            "telephone_number": "812-634-1211",
            "fax_number": "812-634-9762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSEN",
        "first_name": "KELSEY",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-09",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001694A",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50003807",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0090771",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "VONDERHEIDE",
            "middle_name": "R",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jasper, IN

Sources for this page

Verify at the official NPI Registry.