Individual provider Active NPI

Kelly Lynn Wright

  • Acute Care Nurse Practitioner
  • Macon, GA
National Provider Identifier
1184098618
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN180792 Issued in GA
Practice address
777 Hemlock St
Macon, GA 31201-2102
Phone
(478) 741-7241
NPI assigned
Nov 20, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN180792 GA Primary

Addresses

Primary practice location

777 Hemlock St
Macon, GA 31201-2102

Mailing address

777 Hemlock St
Macon, GA 31201-2102
Phone (478) 741-7241

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
I20160518001482 GA Practitioner - Nurse Practitioner 9335438142 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN180792GAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pruitthealth Hospice, Inc. CurrentSince Apr 1, 2019 Accepting new patients
Pruitthealth Hospice, Inc. CurrentSince Apr 1, 2019 Accepting new patients
Pruitthealth Hospice, Inc Current Accepting new patients
Magna Care Medical Specialists LLC CurrentSince Sep 1, 2016 Accepting new patients

Locations

657 Hemlock St
Ste 220
Macon, GA 31201
Phone (478) 741-7241

400 Charter Blvd
Macon, GA 31210
Phone (478) 757-6000

350 Hospital Dr
Macon, GA 31217
Phone (478) 751-0367

6060 Lakeside Commons Dr
Macon, GA 31210
Phone (478) 745-9204

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

1626 Jeurgens Ct
Norcross, GA 30093
Phone (770) 806-6875

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.

NPI Registry JSON

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

{
    "created_epoch": "1447977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447977600000",
    "number": "1184098618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012102",
            "telephone_number": "478-741-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012102",
            "telephone_number": "478-741-7241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-20",
        "last_updated": "2015-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN180792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.