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KELSEY DOWNTON APRN
NPI 1962048694
Nurse Practitioner in Crestview Hills, KY

Active since November 18, 2019PECOS EnrolledAccepts Medicare Assignment
87.53/100
CMS Quality Rating
320 THOMAS MORE PKWY STE 202, CRESTVIEW HILLS, KY 41017(859) 331-0432(859) 331-0956 Get Directions Write a Review

NPPES record last updated: June 9, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 9, 2022, Feb 13, 2020, Jan 27, 2020 and 2 more (5 updates tracked since 2019).

About Kelsey Downton Aprn NPPES

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

KELSEY DOWNTON APRN (NPI 1962048694) is an individual nurse practitioner in Crestview Hills, Kentucky, licensed in Kentucky (3014243) and active in the NPI registry since November 2019. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of University Of Cincinnati College Of Medicine (2019).

NPPES Registry Identity

NPI1962048694
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameKELSEY DOWNTONCredential: APRN
Location Address320 THOMAS MORE PKWY STE 202Crestview Hills, KY 41017-3456
Mailing AddressPo Box 21890Belfast, ME 04915-4115 · (502) 907-0356 · Fax (502) 919-9780
Phone(859) 331-0432
Fax(859) 331-0956
Sole ProprietorNo
Medical School CMSUniversity Of Cincinnati College Of MedicineGraduated 2019
Enumeration DateNovember 18, 2019
Last NPPES UpdateJune 9, 20225 updates tracked since enumeration
NPPES CertifiedJune 9, 2022
✔ NPI 1962048694 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Licenses✔ Licensed in KY · 3014243✔ Licensed in OH · APRN.CNP.025539
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
320 THOMAS MORE PKWY STE 202, Crestview Hills, KY 41017
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1309 11th StCarrollton, KY 41008-1435 · Phone (502) 855-7200 · Fax (502) 855-7201
Location 27300 Beechmont AveCincinnati, OH 45230-4119 · Phone (513) 975-0377

Other Identifiers 3

Medicaid0380807OH
Medicaid300059895IN
Medicaid7100652020KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, 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 and accepts Medicare assignment

Kelsey Downton Aprn 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 ID2163856097
PECOS Enrollment IDI20200214001859
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 6

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.

Testing for presence of drug, by chemistry analyzers 80307
Chemistry analyzers are used to detect the presence of drugs in your system. This test involves taking a small sample of your blood or urine. The sample is then analyzed for specific substances. The results help in understanding your health condition better.
234 services120 patients
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms G0481
A definitive drug test is a detailed analysis used to identify specific drugs in your system. It uses advanced techniques, such as gc/ms and lc/ms, to detect and distinguish between different drugs, even those with similar structures.
195 services101 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.
94 services68 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
81 services58 patients
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms G0480
A definitive drug test is a detailed examination that can identify specific drugs in your system, even closely related ones. Techniques like GC/MS and LC/MS are used for high precision. This helps ensure accurate results for your safety and health.
41 services24 patients
Care management services for behavioral health conditions, 20 minutes or more clinical staff time directed by health care professional 99484
Care management for behavioral health involves a healthcare professional directing clinical staff to provide you with support for 20 minutes or more. This service can include planning your care, coordinating services, and managing your health conditions to improve your overall well-being.
24 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41017 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.

Medicare 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.

87.53/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality80.58
Promoting Interoperability100
Improvement Activities40
Cost68.08

Reported Quality Measures

Advance Care Plan
95%309 patients4/55-star benchmark: 100%
Controlling High Blood Pressure
61%41 patients3/55-star benchmark: 91%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
100%93 patients1/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
98%1,882 patients4/55-star benchmark: 100%
e-Prescribing
100%309 patients5/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
36%968 patients2/55-star benchmark: 98%
Provide Patients Electronic Access to Their Health Information
92%487 patients4/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
82%102 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 8% · 325 patients
Patients totalRate: 18% · 325 patients
10%325 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 4

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

COMMONWEALTH PAIN ASSOCIATES PLLC
Durable Medical Equipment & Medical Supplies
320 THOMAS MORE PKWY STE 202
CRESTVIEW HILLS, KY 41017
Kenton County (859) 331-0432
COMMONWEALTH PAIN ASSOCIATES PLLC
Non-Pharmacy Dispensing Site
320 THOMAS MORE PKWY STE 202
CRESTVIEW HILLS, KY 41017
Kenton County (859) 331-0432
MRS. RUTH ELLEN BARONE MSN, APRN, FNP-BC
Nurse Practitioner (Family)
320 THOMAS MORE PKWY STE 202
CRESTVIEW HILLS, KY 41017
Kenton County (593) 310-4328
KAYCE DANIELLE DAUGHERTY FNP-C
Nurse Practitioner (Family)
320 THOMAS MORE PKWY STE 202
CRESTVIEW HILLS, KY 41017
Kenton County (859) 331-0432

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 Kelsey Downton's NPI number?

The NPI number for Kelsey Downton is 1962048694. It was assigned to this individual provider in the NPPES registry on November 18, 2019.

Where is Kelsey Downton located?

Kelsey Downton practices at 320 Thomas More Pkwy Ste 202, Crestview Hills, KY 41017. The listed phone number is (859) 331-0432.

What is Kelsey Downton's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Kelsey Downton enrolled in Medicare?

Yes. Kelsey Downton 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.

What insurance does Kelsey Downton accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and Molina Healthcare list Kelsey Downton 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 Kelsey Downton was last updated on June 9, 2022. 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.