Kellye Garrett, APMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R855689 Issued in MS

Practice address

2100 East Chambers Drive
Booneville, MS 38829

Phone

(662) 728-3174

Fax

(662) 728-3175

NPI assigned

Apr 27, 2007

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

Other names 1

• Mrs. Kellye Brown Former name

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

Specialty

Nurse Practitioner

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Group practices

Region IV Mental Health ServicesGroup PAC ID 4688733991, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Region IV Mental Health Services

  dba Timber Hills Mental Health

  • Community/Behavioral Health Agency
  • Booneville, MS
  • NPI 1699869537
  Medicare reassignment Care Compare group NPD
• Region IV Desoto County Pharmacy

  • Community/Retail Pharmacy
  • Hernando, MS
  • NPI 1689915423
  NPD
• Region IV Mental Health Services

  • Community/Behavioral Health Agency
  • Ripley, MS
  • NPI 1467671412
  NPD

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1184844466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 839",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "38835",
            "telephone_number": "662-286-9883",
            "fax_number": "662-284-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 EAST CHAMBERS DRIVE",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "38829",
            "telephone_number": "662-728-3174",
            "fax_number": "662-728-3175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "KELLYE",
        "name_prefix": "Mrs.",
        "credential": "APMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-27",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "R855689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "R855689",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLYE",
            "last_name": "BROWN",
            "prefix": "MRS.",
            "credential": "APMHNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aaron Ford
• Melissa Ford, OT
• Alan Gammill, BA
• Grady Gardner, DPT
• Sandra Garner, B.S
• Nestly Gates, BSW
• Gilbert's Hospice Care, LLC (Gentiva)
• Aysha Glidewell
• Danita Godwin, CCSS
• Ken G Goodwin, DMD, PA

• Psychiatric/Mental Health Nurse Practitioner in Booneville, MS
• Providers in Booneville, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.