Louise Rodes Kelly, MSPAS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1569 Issued in KY

Practice address

1221 S Broadway
Lexington, KY 40504-2701

Phone

(859) 258-6101

Fax

(859) 258-4411

NPI assigned

Jul 10, 2010

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Lhy Wellness LLC

  • Family Medicine Physician
  • Lexington, KY
  • NPI 1588445837
  NPD (past)
• Physician Services PSC

  • Pain Medicine Physician
  • Lexington, KY
  • NPI 1558334466

  Physician Assistant

  NPD (past)
• Physician Services PSC

  • Durable Medical Equipment & Medical Supplies
  • Somerset, KY
  • NPI 1861826083

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1278720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1982916631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-6200",
            "fax_number": "859-258-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-6101",
            "fax_number": "859-258-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "LOUISE",
        "middle_name": "RODES",
        "credential": "MSPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-10",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100242930",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Robert Kelly, M.D.
• Grace Kelly
• John David Kelly, PT
• Judith Flore Kelly, APRN
• Kimberly Kelly, CADC
• Paige Mackenzie Kelly, PT, DPT
• Shyanna Mikole Kelly, BSW
• Gabrielle Kelm
• Kimberly B Kelsay, CSW
• Kelsey Dunkin

• Physician Assistant in Lexington, KY
• Providers in Lexington, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.