MRS. COURTNEY ANN KELLY PA-C
NPI 1265628275
Physician Assistant - Medical in Morris, IL

Q: What is Courtney Kelly's NPI number?

The NPI number for Courtney Kelly is 1265628275. It was assigned to this individual provider in the NPPES registry on September 24, 2007. The provider is also known as Ms. Courtney Ann Verdeyen Pa-C.

Q: What is Courtney Kelly's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Courtney Kelly was last updated on December 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since September 24, 2007PECOS Enrolled

1345 EDWARDS ST STE 2, MORRIS, IL 60450(815) 942-1421(815) 488-2033 Get Directions Write a Review

NPPES record last updated: December 17, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mrs. Courtney Ann Kelly Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. COURTNEY ANN KELLY PA-C (NPI 1265628275) is an individual medical provider in Morris, Illinois, licensed in Illinois (085003055) and active in the NPI registry since September 2007. She is enrolled in Medicare PECOS and maintains a secondary practice location in Lake Zurich.

NPPES Registry Identity

NPI1265628275

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameMRS. COURTNEY ANN KELLYCredential: PA-C

Location Address1345 EDWARDS ST STE 2Morris, IL 60450-1692

Mailing Address725 School St Ste AMorris, IL 60450-1207 · (815) 941-9124 · Fax (815) 941-4363

Phone(815) 942-1421

Fax(815) 488-2033

Sole ProprietorNo

Enumeration DateSeptember 24, 2007

Last NPPES UpdateDecember 17, 2020

NPPES CertifiedDecember 17, 2020

✔ NPI 1265628275 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in IL · 085003055

1345 EDWARDS ST STE 2, Morris, IL 60450

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Other Names 1

Former Name (1)Ms. Courtney Ann Verdeyen Pa-c

Secondary Practice Location 1

Location 1350 Surryse Rd, Suite 100Lake Zurich, IL 60047-3217 · Phone (847) 438-2144 · Fax (847) 719-0335

Other Identifiers 1

Other085.003055IL · Il License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Courtney Ann Kelly Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier12 claims12 services$11.11 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$52.55 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

1 supplier19 claims19 services$176.09 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAYNEE E PENDERGAST DO

Family Medicine

1345 EDWARDS ST STE 2
MORRIS, IL 60450

Grundy County (815) 942-1421

STEPHANIE K WHITMER MD

Family Medicine

1345 EDWARDS ST STE 2
MORRIS, IL 60450

Grundy County (815) 942-1421

DR. VINCENT RAFER BENIG M.D.

Family Medicine

1345 EDWARDS ST STE 2
MORRIS, IL 60450

Grundy County (815) 942-1421

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 Courtney Kelly's NPI number?

The NPI number for Courtney Kelly is 1265628275. It was assigned to this individual provider in the NPPES registry on September 24, 2007. The provider is also known as Ms. Courtney Ann Verdeyen Pa-C.

Where is Courtney Kelly located?

Courtney Kelly practices at 1345 Edwards St Ste 2, Morris, IL 60450. The listed phone number is (815) 942-1421.

What is Courtney Kelly's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Courtney Kelly enrolled in Medicare?

Yes. Courtney Kelly is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Courtney Kelly was last updated on December 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.