Alisa Britney Kelley, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

903974 Issued in MS

Practice address

120 E Myrtle St
Magnolia, MS 39652-2834

Phone

(601) 869-7330

Fax

(601) 783-5812

NPI assigned

Jul 4, 2020

Sex

Female

Sole proprietor

Yes

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.

• Freedom Hospital of Magnolia LLC

  • General Practice Physician
  • Magnolia, MS
  • NPI 1598212490

  MS

  Medicare reassignment Care Compare group
• Freedom Hospital of Magnolia LLC

  • Rural Health Clinic/Center
  • Magnolia, MS
  • NPI 1235686130
  Care Compare group NPD (past)
• Freedom Hospital of Magnolia LLC

  • Medicare Defined Swing Bed Hospital Unit
  • Magnolia, MS
  • NPI 1942501507
  Care Compare group
• Freedom Hospital of Magnolia, LLC

  • Rural Acute Care Hospital
  • Magnolia, MS
  • NPI 1871953802
  Care Compare group

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

• Freedom Hospital of Magnolia, LLC

  • Rural Acute Care Hospital
  • Magnolia, MS
  • NPI 1871953802

  Hospital

  Care Compare affiliation
• Southwest Mississippi Regional Medical Center

  • General Acute Care Hospital
  • McComb, MS
  • NPI 1407805971

  Hospital

  Care Compare affiliation

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Freedom Hospital of Magnolia LLC 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beacham Memorial Hospital Hospital, Magnolia, MS, CCN 250049
• Southwest Ms Regional Medical Center Hospital, McComb, MS, CCN 250097

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 23, 2020.

{
    "created_epoch": "1593820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1023635166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E MYRTLE ST",
            "city": "MAGNOLIA",
            "state": "MS",
            "postal_code": "396522834",
            "telephone_number": "601-869-7330",
            "fax_number": "601-783-5812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E MYRTLE ST",
            "city": "MAGNOLIA",
            "state": "MS",
            "postal_code": "396522834",
            "telephone_number": "601-869-7330",
            "fax_number": "601-783-5812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "ALISA",
        "middle_name": "BRITNEY",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-04",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "McComb",
            "affiliation": "N",
            "address_1": "1023 Chesterfield Dr",
            "city": "McComb",
            "state": "MS",
            "country_code": "US",
            "postal_code": "396489560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Freedom Hospital of Magnolia LLC
• Freedom Hospital of Magnolia LLC
• Freedom Hospital of Magnolia, LLC
• Doris Glenda Holliday
• Amy Keller, RCS,RVS
• Kingdom House LLC
• Lampton Medical Associates, P.a.
• Lucius M. Lampton, M.D.
• George H Leggett, D.D.S.
• Kimberly Renee Lemaster, FNP

• All providers in Magnolia, MS
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.