Kellie Whitener

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN213296 Issued in GA

Practice address

23702 Hwy 80 E
Statesboro, GA 30461-0845

Phone

(912) 489-4090

Fax

(912) 764-5028

NPI assigned

Dec 16, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Health Care Center, PCGroup PAC ID 4082601299, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• East Georgia Regional Medical Center Hospital, Statesboro, GA, CCN 110075

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kellie.whitener.p1@direct.familyhealthcare.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Family Health Care Center, PC

  • Clinic/Center
  • Statesboro, GA
  • NPI 1205855988
  Medicare reassignment Care Compare group NPD

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

• East Georgia Regional Medical Center, LLC

  • General Acute Care Hospital
  • Statesboro, GA
  • NPI 1265486278
  Care Compare affiliation

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1093301855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23702 HWY 80 E",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304610845",
            "telephone_number": "912-489-4090",
            "fax_number": "912-764-8378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23702 HWY 80 E",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304610845",
            "telephone_number": "912-489-4090",
            "fax_number": "912-764-5028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITENER",
        "first_name": "KELLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-16",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN213296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA LICENSE",
            "identifier": "RN213296",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "0509.0001@direct.familyhealthcare.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "family health care center direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "23702 Hwy 80 E",
            "city": "Statesboro",
            "state": "GA",
            "country_code": "US",
            "postal_code": "304610845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pamela Wells
• Westwood Pac LLC
• Allison White
• Kaitlyn White
• Aelicia Whitehead
• Paul Austin Whitlock III, M.D.
• Alecia Wiggins
• Neil Wesley Wilkerson, PA-C
• Benny Keith Wilkey, LMSW
• Aneytraei' Williams

• Family Nurse Practitioner in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.