Kelli Bearden, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R882184 Issued in MS

Practice address

1502 S Colorado St
Greenville, MS 38703-7219

Phone

(662) 332-9872

NPI assigned

Sep 3, 2014

Last updated

Sep 3, 2014By the provider in NPPES

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

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

State licenses

Practice roles

Locations

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

• Bolivar Physician Practices LLC

  dba Bolivar Orthopedics

  • Orthopaedic Surgery Physician
  • Cleveland, MS
  • NPI 1063659530
  Medicare reassignment NPD
• Bolivar Physician Practices LLC

  dba Rosedale Family Medical

  • Rural Health Clinic/Center
  • Rosedale, MS
  • NPI 1205489689
  NPD

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1144620592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 PINE CIRCLE",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "38751",
            "telephone_number": "662-836-4310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 S COLORADO ST",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387037219",
            "telephone_number": "662-332-9872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARDEN",
        "first_name": "KELLI",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-03",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R882184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa S Baker, RPA/RA
• Renate Esther Baker, RRT
• Denetrius Banks
• Patricia Ann Barber, NP-C
• Thea A Barnes, LPN
• John Houston Bearry, MD
• James R Beckham, MD
• Ryginna D Bennett, NP
• Djuana Matthews Beruk, D.D.S.
• Bethesda Resources Inc (Bethesda Cancer Center)

• Nurse Practitioner in Greenville, MS
• Providers in Greenville, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.