NPIMap

Individual provider Active NPI

Kelsey Marter Faulkner

  • Family Nurse Practitioner
  • Charleston, MS
National Provider Identifier
1013489319
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
903087 Issued in MS
Practice address
171 Dr TT Lewis Cir
Charleston, MS 38921-2400
Phone
(662) 647-5816
NPI assigned
Dec 26, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 903087 MS Primary

Addresses

Primary practice location

171 Dr TT Lewis Cir
Charleston, MS 38921-2400

Mailing address

221 Dale Rd
Duck Hill, MS 38925-9241
Phone (662) 614-6283

Other names 1

  • Kelsey M Moncrief Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190827002889 MS Practitioner - Nurse Practitioner 9739417882 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tallahatchie General Hospital 20 clinicians

Practice addresses (Care Compare)

1301 Sunset Dr
Suite E
Grenada, MS 38901-4103
Phone (662) 625-7191

141 Dr T T Lewis Circle
Charleston, MS 38921-2236
Phone (662) 647-5392

141 Dr TT Lewis Cir
Charleston, MS 38921-2400
Phone (662) 625-7176

Hospital & facility affiliations

  • Adoration Home Health Care Mississippi Home health agency, Cleveland, MS, CCN 257305
  • Accentcare Home Health of Greenwood Home health agency, Greenwood, MS, CCN 257131
  • Arden Home Health of North Mississippi, LLC Home health agency, Oxford, MS, CCN 257311
  • Tallahatchie General Hospital-Cah Hospital, Charleston, MS, CCN 251304
  • University of Mississippi Medical Center- Grenada Hospital, Grenada, MS, CCN 250168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
903087MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahatchie General Hospital Single Specialty CurrentSince Jul 1, 2022 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Single Specialty CurrentSince Mar 29, 2019 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Mar 29, 2019 Accepting new patients
Tallahatchie General Hospital Single Specialty Current Accepting new patients
Tallahatchie General Hospital CurrentSince Jul 1, 2022 Accepting new patients
Spring Valley Hospice, LLC PastSince Oct 5, 2021 Accepting new patients

Locations

171 Dr TT Lewis Cir
Charleston, MS 38921
Phone (662) 625-7176

1301 Sunset Dr
Ste E
Grenada, MS 38901
Phone (662) 229-0069

965 Avent Dr
Ste 100A
Grenada, MS 38901
Phone (662) 227-7000

965 Avent Dr
Grenada, MS 38901
Phone (662) 227-6426

960 Avent Dr
Grenada, MS 38901
Phone (662) 227-7000

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

2500 N State St
#4200
Jackson, MS 39216

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1013489319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 DALE RD",
            "city": "DUCK HILL",
            "state": "MS",
            "postal_code": "389259241",
            "telephone_number": "662-614-6283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 DR TT LEWIS CIR",
            "city": "CHARLESTON",
            "state": "MS",
            "postal_code": "389212400",
            "telephone_number": "662-647-5816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "KELSEY",
        "middle_name": "MARTER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-26",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "MONCRIEF",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charleston, MS

Sources for this page

Verify at the official NPI Registry.