Kelly Russell Burris, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0021469439 Issued in VA

Practice address

109 Carrol Dr
Fries, VA 24330-4532

Phone

(888) 908-4788

Fax

(276) 398-3331

NPI assigned

Jun 20, 2011

Last updated

Oct 11, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Kelly Michele Russell Former name

Medicare fee-for-service enrollment

Enrolled in VA

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tri Area Community HealthGroup PAC ID 6204748296, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Access Home Health Care and Rehabilitation Home health agency, Galax, VA, CCN 497713
• Twin County Regional Hospital Hospital, Galax, VA, CCN 490115

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.

• Tri Area Community Health

  dba Tri Area Community Health at Laurel Fork

  • Federally Qualified Health Center (FQHC)
  • Laurel Fork, VA
  • NPI 1346227584
  Medicare reassignment Care Compare group NPD
• Emergency Physicians of Southern Virginia LLP

  • Emergency Medicine Physician
  • Galax, VA
  • NPI 1417187667

  Nurse Practitioner

  Medicare reassignment NPD
• Emergency Coverage Services, PC

  • Nurse Practitioner
  • Lawrenceburg, TN
  • NPI 1053351593

  VA

  Medicare reassignment NPD
• Tri Area Community Health

  dba Tri Area Community Health at Grayson County Schools

  • Federally Qualified Health Center (FQHC)
  • Independence, VA
  • NPI 1891676300
  NPD
• Tri Area Community Health

  dba Tri Area Community Health at Galax

  • Federally Qualified Health Center (FQHC)
  • Galax, VA
  • NPI 1689355927
  NPD (past)

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

• Access Home Health Care and Rehabilitation, LLC

  dba Access Home Health Care and Rehabilitation

  • Home Health Agency
  • Galax, VA
  • NPI 1508267444
  Care Compare affiliation
• DLP Twin County Regional Healthcare LLC

  dba Twin County Regional Hospital

  • General Acute Care Hospital
  • Galax, VA
  • NPI 1114292141
  Care Compare affiliation
• DLP Twin County Regional Healthcare LLC

  • Physical Therapy Clinic/Center
  • Galax, VA
  • NPI 1801161369

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760140800000",
    "number": "1194011007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "LAUREL FORK",
            "state": "VA",
            "postal_code": "243520009",
            "telephone_number": "276-398-1200",
            "fax_number": "336-789-0856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CARROL DR",
            "city": "FRIES",
            "state": "VA",
            "postal_code": "243304532",
            "telephone_number": "888-908-4788",
            "fax_number": "276-398-3331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Maroon Tide Dr",
            "address_purpose": "LOCATION",
            "city": "Galax",
            "state": "VA",
            "postal_code": "243334238",
            "country_code": "US",
            "telephone_number": "888-908-4788",
            "fax_number": "276-398-3331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14558 Danville Pike",
            "address_purpose": "LOCATION",
            "city": "Laurel Fork",
            "state": "VA",
            "postal_code": "243523982",
            "country_code": "US",
            "telephone_number": "276-398-2292",
            "fax_number": "276-398-3331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURRIS",
        "first_name": "KELLY",
        "middle_name": "RUSSELL",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-20",
        "last_updated": "2025-10-11",
        "certification_date": "2025-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5007750",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5007750",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0021469439",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024169439",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "RUSSELL",
            "middle_name": "MICHELE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dawn Bullins
• Michael A Cobler, LPC
• Joy K Creed, FNP-C
• Fries Community Health Care Inc
• Fries Community Health Care Inc
• Fries Family Care Center PC

• Family Nurse Practitioner in Fries, VA
• Providers in Fries, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2025; 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.