KELLY ELI DAUGHERTY PA-C
NPI 1548635014
Physician Assistant in Owatonna, MN

Q: What is Kelly Daugherty's NPI number?

The NPI number for Kelly Daugherty is 1548635014. It was assigned to this individual provider in the NPPES registry on December 9, 2015. The provider is also known as Kelly Allen Widiger Pa-C.

Q: What is Kelly Daugherty's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Daugherty was last updated on February 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 December 09, 2015PECOS EnrolledAccepts Medicare Assignment

2200 NW 26TH ST, OWATONNA, MN 55060(507) 451-1120 Get Directions Write a Review

NPPES record last updated: February 9, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 9, 2024, Nov 1, 2021, Sep 28, 2020 and 5 more (8 updates tracked since 2015).

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About Kelly Eli Daugherty Pa-c NPPES

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

KELLY ELI DAUGHERTY PA-C (NPI 1548635014) is an individual physician assistant in Owatonna, Minnesota, licensed in Minnesota (12173) and active in the NPI registry since December 2015. He is enrolled in Medicare PECOS, is affiliated with M Health Fairview University Of Mn, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1548635014

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameKELLY ELI DAUGHERTYCredential: PA-C

Location Address2200 NW 26TH STOwatonna, MN 55060-5503

Mailing Address2200 Nw 26th StOwatonna, MN 55060-5503 · (507) 451-1120

Phone(507) 451-1120

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateDecember 9, 2015

Last NPPES UpdateFebruary 9, 20248 updates tracked since enumeration

NPPES CertifiedFebruary 9, 2024

✔ NPI 1548635014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MN · 12173

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License PAC0622 (ND)

2200 NW 26TH ST, Owatonna, MN 55060

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Other Names 1

Former Name (1)Kelly Allen Widiger Pa-c

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Eli Daugherty Pa-c 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.

PECOS PAC ID7719289867

PECOS Enrollment IDI20170406000743

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.

Areas of Expertise CMS Part B claims 3

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.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

39 services39 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

32 services27 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

13 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

M Health Fairview University Of Mn

Acute Care Hospitals · Minneapolis, MN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240080

Location2450 Riverside AvenueMinneapolis, MN 55454 · Hennepin County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55060 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

KAYLA MARIE COOK PA-C

Physician Assistant