William David Kelley, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA1058 Issued in NV

Practice address

100 N Green Valley Pkwy
Suite 310
Henderson, NV 89074-6391

Phone

(702) 565-6565

Fax

(702) 565-8898

NPI assigned

May 10, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

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

Specialty

Physician Assistant

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Craig M Jorgenson MD LTDGroup PAC ID 0941103303, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

20.89 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

69.64

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Craig M Jorgenson MD LTD

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1831261460
  Medicare reassignment Care Compare group
• Richard E Obringer Pac Prof Corp

  • Surgical Physician Assistant
  • Las Vegas, NV
  • NPI 1417037698
  Medicare reassignment
• Yang Medical Services, PLLC

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1538729322
  Medicare reassignment

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1952351272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N GREEN VALLEY PKWY",
            "address_2": "SUITE 310",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890746391",
            "telephone_number": "702-565-6565",
            "fax_number": "702-565-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N GREEN VALLEY PKWY",
            "address_2": "SUITE 310",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890746391",
            "telephone_number": "702-565-6565",
            "fax_number": "702-565-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "WILLIAM",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NV",
            "license": "PA1058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00442052",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keller- Wells & Associates, P.C.
• Alecsa Keller
• Deanna Keller
• Cheri Ann Kelley, LCSW INTERN
• Chrstine Brooke Kelley
• Angela Dawn Kelly, PHARMD
• Faye Kelly, A.S.
• Korrin Taylor Kelly
• Ronald Kelly
• Shanita Kelly

• Surgical Physician Assistant in Henderson, NV
• Providers in Henderson, NV by specialty
• Surgical Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.
• 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.