KELSEY CHILDRESS M.D.
NPI 1902250772
Student in an Organized Health Care Education/Training Program in Sacramento, CA

Q: What is Kelsey Childress's NPI number?

The NPI number for Kelsey Childress is 1902250772. It was assigned to this individual provider in the NPPES registry on April 19, 2016.

Q: What is Kelsey Childress's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Kelsey Childress was last updated on December 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 April 19, 2016PECOS Enrolled

6600 BRUCEVILLE RD, SACRAMENTO, CA 95823(916) 688-6800 Get Directions Write a Review

NPPES record last updated: December 22, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 22, 2021, Jun 10, 2019 (2 updates tracked since 2019).

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About Kelsey Childress M.d. NPPES

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

KELSEY CHILDRESS M.D. (NPI 1902250772) is an individual student in an organized health care education/training program in Sacramento, California and active in the NPI registry since April 2016. She is enrolled in Medicare PECOS and maintains a secondary practice location in Sacramento.

NPPES Registry Identity

NPI1902250772

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameKELSEY CHILDRESSCredential: M.D.

Location Address6600 BRUCEVILLE RDSacramento, CA 95823-4671

Mailing Address6600 Bruceville RdSacramento, CA 95823-4671 · (916) 688-6800

Phone(916) 688-6800

Sole ProprietorNo

Enumeration DateApril 19, 2016

Last NPPES UpdateDecember 22, 20212 updates tracked since enumeration

✔ NPI 1902250772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

6600 BRUCEVILLE RD, Sacramento, CA 95823

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Secondary Practice Location 1

Location 16600 Bruceville RdSacramento, CA 95823-4671 · Phone (916) 688-6800

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelsey Childress M.d. 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.

Medicare Billing Reassignment

Medicare enrollment records show Kelsey Childress reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc

32 mi

Internal Medicine

7373 WEST LANE
Stockton, CA 95210

Reassigned Medicare billing, California enrollment
20,078 clinicians in this Medicare group

NPI 1548343510 (209) 476-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

SHANNON KENTERA CRNA

Nurse Anesthetist, Certified Registered