Individual provider Active NPI

Mykayla Grace Kelley-Montes, FNP-C

  • Family Nurse Practitioner
  • Danville, VA
National Provider Identifier
1063133874
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F09220139 Issued in NC
Practice address
142 S Main St
Danville, VA 24541-2922
Phone
(434) 799-2100
NPI assigned
Sep 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F09220139 NC Primary

Addresses

Primary practice location

142 S Main St
Danville, VA 24541-2922

Mailing address

1004 Chancellors Ridge Dr
Durham, NC 27713-6068
Phone (423) 883-1821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221027000280 VA Practitioner - Nurse Practitioner 7416363064 Reassigns benefits to 2 organizations
I20240625000781 GA Practitioner - Nurse Practitioner 7416363064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians

Practice addresses (Care Compare)

320 Hospital Dr
Martinsville, VA 24112-1981
Phone (276) 666-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F09220139NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage Services, PC CurrentSince Nov 18, 2022 Accepting new patients
Gordon Emergency Physicians, LLC CurrentSince Jun 1, 2024 Accepting new patients
Emergency Coverage, LLC CurrentSince Jul 1, 2024 Accepting new patients
Gordon Emergency Physicians, LLC CurrentSince Jun 1, 2024 Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

1035 Red Bud Rd NE
Calhoun, GA 30701
Phone (706) 602-7800

142 S Main St
Danville, VA 24541
Phone (434) 799-2100

320 Hospital Dr
Martinsville, VA 24112
Phone (276) 666-7200

6801 Governor Gc Peery Hwy
Richlands, VA 24641
Phone (276) 523-8600

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 4

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 2

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": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1063133874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 CHANCELLORS RIDGE DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136068",
            "telephone_number": "423-883-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 S MAIN ST",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245412922",
            "telephone_number": "434-799-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY-MONTES",
        "first_name": "MYKAYLA",
        "middle_name": "GRACE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-09",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F09220139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

Verify at the official NPI Registry.