NPIMap

Individual provider Active NPI

Stacey L Kelley, FNP-C

  • Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1972989267
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3009353 Issued in KY
Practice address
3 Audubon Plaza Dr
Ste 560
Louisville, KY 40217-1300
Phone
(502) 567-2628
NPI assigned
Aug 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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 3009353 KY Primary

Addresses

Primary practice location

3 Audubon Plaza Dr
Ste 560
Louisville, KY 40217-1300

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address skelley45929@direct.nortonhealthcare.org
FHIR URL https://epicsoap.nortonhealthcare.org/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20150902002704 KY Practitioner - Nurse Practitioner 9335455526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

Hospital & facility affiliations

  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088
  • Norton Clark Hospital Hospital, Jeffersonville, IN, CCN 150009

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
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Nurse Practitioner Current Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner CurrentSince Oct 1, 2015 Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner CurrentSince Oct 1, 2015 Accepting new patients

Locations

1858 Old Lebanon Rd
Campbellsville, KY 42718
Phone (270) 465-0632

2410 Ring Rd
Ste 500
Elizabethtown, KY 42701
Phone (270) 765-5900

912 Wallace Ave
Ste 104
Leitchfield, KY 42754
Phone (270) 287-0001

210 E Gray St
Ste 1002
Louisville, KY 40202
Phone (502) 584-2027

2355 Poplar Level Rd
Ste G1
Louisville, KY 40217
Phone (502) 636-8121

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

3 Audubon Plaza Dr
Ste 220
Louisville, KY 40217
Phone (502) 636-7242

4420 Dixie Hwy
Ste 118
Louisville, KY 40216
Phone (502) 447-3448

2355 Poplar Level Rd
Ste 405
Louisville, KY 40217
Phone (502) 636-7845

3 Audubon Plaza Dr
Ste 560
Louisville, KY 40217
Phone (502) 636-8004

901 DuPont Rd
Ste 200
Louisville, KY 40207

Interoperability endpoints

  • Direct secure messaging: skelley45929@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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1972989267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 AUDUBON PLAZA DR",
            "address_2": "STE 560",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171300",
            "telephone_number": "502-567-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "STACEY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-10",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3009353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skelley45929@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "3 Audubon Plaza Dr",
            "address_2": "Ste 560",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402171300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/",
            "affiliation": "N",
            "address_1": "3 Audubon Plaza Dr",
            "address_2": "Ste 560",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402171300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.