DR. KELLY J. MCELLIGOTT (AU.D., CCC-A) – Audiologist, NPI 1104342864

DR. KELLY J. MCELLIGOTT (AU.D., CCC-A) is a healthcare provider. based in Knoxville, Tennessee. specializing in QUALIFIED AUDIOLOGIST. They hold the professional credentials AU.D., CCC-A. They hold a License No. 2201002004 (VA). The NPI Number for DR. KELLY J. MCELLIGOTT (AU.D., CCC-A) is 1104342864

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
DR. KELLY J. MCELLIGOTT (AU.D., CCC-A)
NPI
1104342864
Phone
(865) 693-6065
Address
9430 PARK WEST BLVD STE 335
Enumeration Date
15 August 2017
Last Update Date
7 February 2025

Doctor Profile

Medical School Name
UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Secondary Phone
8043738224
Graduation Year
2017 (9 years ago)
PAC ID
1557626678
Group Practice PAC ID
8224458054
Professional Enrollment ID
I20250225002785
Address ID
VA232361256NO9513XDRXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:8State licenses:1Digital endpointsOther names

279 QUALIFIED AUDIOLOGIST in VA

Provider Addresses for DR. KELLY J. MCELLIGOTT (AU.D., CCC-A)

  • Park West Boulevard, Knoxville, Knox County, Tennessee, United States

    KNOXVILLE, TN 379234206

    Phone: (865) 693-6065

    Type: Mailing

  • 9513 AMBERDALE DR

    NORTH CHESTERFIELD, VA 232361256

    Phone: (804) 373-8224

    Fax: (804) 369-9658

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-02-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180521000455IQualified AudiologistTNTBD
I20250225002785IQualified AudiologistVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92557Comprehensive hearing and speech recognition test6464$0
92567Test to assess middle ear function6161$0
92626Evaluation of hearing function related to surgically implanted hearing device, first hour2018$0
92604Analysis and reprogramming of inner ear implant (7 years or older)1712$0
View full utilization report →

Insurance plans in this area (ZIP 37923)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8224458054View full group profile
NameSpecialtyState
Qualified AudiologistVA

Reviews

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Frequently asked questions

Is there an official ID for DR. KELLY J. MCELLIGOTT (AU.D., CCC-A) in U.S. healthcare records?
The official identifier for DR. KELLY J. MCELLIGOTT (AU.D., CCC-A) is NPI 1104342864.
Active or inactive — what applies to DR. KELLY J. MCELLIGOTT (AU.D., CCC-A)?
You should see DR. KELLY J. MCELLIGOTT (AU.D., CCC-A) as active in CMS-hosted NPPES data.
How would a patient describe DR. KELLY J. MCELLIGOTT (AU.D., CCC-A)'s focus?
For DR. KELLY J. MCELLIGOTT (AU.D., CCC-A), the primary taxonomy reads as Audiologist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. KELLY J. MCELLIGOTT (AU.D., CCC-A)?
Travel planning: use Knoxville, Tennessee as the reference point for DR. KELLY J. MCELLIGOTT (AU.D., CCC-A), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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