KELLIE ADRIENNE PARK MD
NPI 1144481466
Anesthesiology in Seymour, IN
About Kellie Adrienne Park Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLIE ADRIENNE PARK MD (NPI 1144481466) is an individual anesthesiology provider in Seymour, Indiana, licensed in Indiana (01073835A) and active in the NPI registry since June 2008. She is enrolled in Medicare PECOS, is affiliated with Johnson Memorial Hospital, and is a graduate of Indiana University School Of Medicine (2008).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kellie Adrienne Park Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Kellie Park reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Seymour, IN 47274
- Reassigned Medicare billing, Indiana enrollment
- 169 clinicians in this Medicare group
Franklin, IN 46131
- Reassigned Medicare billing, Indiana enrollment
- 97 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 4
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Johnson Memorial Hospital
Acute Care Hospitals · Franklin, INSchneck Medical Center
Acute Care Hospitals · Seymour, INMedicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SEYMOUR, IN 47274
SEYMOUR, IN 47274
SEYMOUR, IN 47274
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kellie Park's NPI number?
The NPI number for Kellie Park is 1144481466. It was assigned to this individual provider in the NPPES registry on June 19, 2008.
Where is Kellie Park located?
Kellie Park practices at 411 W Tipton St Attn: Anesthesia Dept, Seymour, IN 47274. The listed phone number is (812) 524-2738.
What is Kellie Park's specialty?
The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.
Is Kellie Park enrolled in Medicare?
Yes. Kellie Park is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Kellie Park's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kellie Park reassigns Medicare benefits to 2 organizations: Jackson County Schneck Memorial Hospital (Seymour, IN) and Johnson Memorial Hospital (Franklin, IN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kellie Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kellie Park accept?
Health plans from CareSource list Kellie Park as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Kellie Park affiliated with any hospitals?
According to CMS data, Kellie Park is affiliated with Johnson Memorial Hospital and Schneck Medical Center.
When was this NPI record last updated?
The NPPES record for Kellie Park was last updated on January 21, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kellie Adrienne Park, MD · NPI 1144481466
Anesthesiology physician in Seymour, Indiana. Individual provider, active in the CMS NPPES registry since June 19, 2008.
## Identity
- **NPI:** 1144481466 (Entity type: Individual)
- **Enumerated:** June 19, 2008
- **Primary specialty:** Anesthesiology · taxonomy 207L00000X
- **State license:** 01073835A (Indiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 411 W TIPTON ST, ATTN: ANESTHESIA DEPT, Seymour, IN 47274-2363
- **Phone:** (812) 524-2738
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Jackson County Schneck Memorial Hospital (NPI 1629143037, Seymour, IN); Johnson Memorial Hospital (NPI 1346248986, Franklin, IN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Indiana University School Of Medicine, class of 2008
## Record status
- **NPPES last updated:** January 21, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1144481466) · Data from the CMS NPPES public registry.