Individual provider Active NPI

Kelly Celeste Landry, PA-C

  • Physician Assistant
  • Savannah, GA
National Provider Identifier
1154368389
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11526 Issued in GA
Practice address
5353 Reynolds St
Savannah, GA 31405-6015
Phone
(912) 232-9700
Fax
(912) 748-0270
NPI assigned
May 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11526 GA Primary

Addresses

Primary practice location

5353 Reynolds St
Savannah, GA 31405-6015

Mailing address

5501 Abercorn Street
Ste D Box 104
Savannah, GA 31405
Phone (912) 232-9700

Other practice location 1

5356 Reynolds St Ste 201
Savannah, GA 31405-6019
Phone (912) 232-9700 ext. 103

Other practice location 2

11705 Mercy Blvd
Savannah, GA 31419-1711
Phone (912) 232-9700 ext. 103

Other practice location 3

800 E 68th St
Savannah, GA 31405-4710
Phone (912) 232-9700 ext. 103

Other practice location 4

6510 Seawright Dr
Savannah, GA 31406-2752
Phone (912) 232-9700 ext. 103

Other practice location 5

103 E General Stewart Way Ste B
Hinesville, GA 31313-2607
Phone (912) 232-9700 ext. 103

Other identifiers 1

IdentifierTypeStateIssuer
1529095MedicaidLA

Other names 1

  • Kelly Celeste Mondello Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230509000090 GA Practitioner - Physician Assistant 0143297390 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fortis Care, PCGroup PAC ID 8527550144, 14 clinicians
Leewood Medical PCGroup PAC ID 7719204429, 6 clinicians

Practice addresses (Care Compare)

415 Airport Rd
Griffin, GA 30224-4834
Phone (770) 227-8636

5353 Reynolds St
Suite 201
Savannah, GA 31405-6087
Phone 9122329700103

5507 Abercorn St
Suite 103
Savannah, GA 31405-6912

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
11526GAMDPhysician Assistant

Organizations & group practices 3

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.

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1154368389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 ABERCORN STREET",
            "address_2": "STE D BOX 104",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31405",
            "telephone_number": "912-232-9700",
            "fax_number": "912-748-0270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 REYNOLDS ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056015",
            "telephone_number": "912-232-9700",
            "fax_number": "912-748-0270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5356 Reynolds St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314056019",
            "country_code": "US",
            "telephone_number": "912-232-9700 x103",
            "fax_number": "912-748-0270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11705 Mercy Blvd",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314191711",
            "country_code": "US",
            "telephone_number": "912-232-9700 x103",
            "fax_number": "912-748-0270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 E 68th St",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314054710",
            "country_code": "US",
            "telephone_number": "912-232-9700 x103",
            "fax_number": "912-748-0270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6510 Seawright Dr",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314062752",
            "country_code": "US",
            "telephone_number": "912-232-9700 x103",
            "fax_number": "912-748-0270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "103 E General Stewart Way Ste B",
            "address_purpose": "LOCATION",
            "city": "Hinesville",
            "state": "GA",
            "postal_code": "313132607",
            "country_code": "US",
            "telephone_number": "912-232-9700 x103",
            "fax_number": "912-748-0270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "KELLY",
        "middle_name": "CELESTE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1529095",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MONDELLO",
            "middle_name": "CELESTE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.