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DR. TRACE KELLY FNP-C, DC
NPI 1629296603
Nurse Practitioner - Family in Louisville, KY

Active since April 23, 2007PECOS Enrolled
4613 ROXANN BLVD STE 101, LOUISVILLE, KY 40218(502) 415-3943(502) 451-5041 Get Directions Write a Review

NPPES record last updated: July 7, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Trace Kelly Fnp-c, Dc NPPES

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

DR. TRACE KELLY FNP-C, DC (NPI 1629296603) is an individual family provider in Louisville, Kentucky, licensed in Kentucky (3015925) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629296603
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameDR. TRACE KELLYCredential: FNP-C, DC
Location Address4613 ROXANN BLVD STE 101Louisville, KY 40218-4072
Mailing Address4227 Poplar Level RdLouisville, KY 40213-1527 · (502) 451-5959
Phone(502) 415-3943
Fax(502) 451-5041
Sole ProprietorYes
Enumeration DateApril 23, 2007
Last NPPES UpdateJuly 7, 2021
NPPES CertifiedJuly 7, 2021
✔ NPI 1629296603 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in KY · 3015925
Also ListedChiropractor · RehabilitationTaxonomy 111NR0400X · License 4973 (KY)
4613 ROXANN BLVD STE 101, Louisville, KY 40218
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Trace Kelly Fnp-c, Dc 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40218 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Trace Kelly's NPI number?

The NPI number for Trace Kelly is 1629296603. It was assigned to this individual provider in the NPPES registry on April 23, 2007.

Where is Trace Kelly located?

Trace Kelly practices at 4613 Roxann Blvd Ste 101, Louisville, KY 40218. The listed phone number is (502) 415-3943.

What is Trace Kelly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Trace Kelly enrolled in Medicare?

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

What insurance does Trace Kelly accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health and Ambetter of Tennessee list Trace Kelly 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.

When was this NPI record last updated?

The NPPES record for Trace Kelly was last updated on July 7, 2021. 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.