Kelly Marie Harris, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN165420 Issued in GA

Practice address

2069 Kinnett Rd
Milan, GA 31060-4724

Phone

(229) 860-0568

NPI assigned

Jun 29, 2023

Last updated

Jun 29, 2023By 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 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hyperbaric and Woundcare IncGroup PAC ID 1052311560, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Dodge County Hospital Hospital, Eastman, GA, CCN 110092
• Bleckley Memorial Hospital Hospital, Cochran, GA, CCN 111302
• Northside Hospital Hospital, Atlanta, GA, CCN 110161

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.

• Hyperbaric & Woundcare Inc

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Hazlehurst, GA
  • NPI 1780105296
  Medicare reassignment Care Compare group NPD
• Hospital Authority of Jeff Davis County Georgia

  dba Jeff Davis Hospital

  • Critical Access Hospital
  • Hazlehurst, GA
  • NPI 1912902263
  Medicare reassignment NPD
• Hospital Authority of Jeff Davis County Georgia

  dba Jeff Davis Behavioral Health Services

  • Psychiatric Hospital Unit
  • Hazlehurst, GA
  • NPI 1023593498
  NPD
• Hospital Authority of Jeff Davis County Georgia

  dba Family Healthcare Connections

  • Internal Medicine Physician
  • Hazlehurst, GA
  • NPI 1528874518
  NPD
• Hyperbaric & Woundcare Inc

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Tampa, FL
  • NPI 1457308173
  NPD (past)

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

• Bleckley County Hospital

  dba Bleckley Memorial Hospital

  • Critical Access Hospital
  • Cochran, GA
  • NPI 1578637526
  Care Compare affiliation
• Dodge County Hospital Authority

  dba Dodge County Hospital

  • Rural Acute Care Hospital
  • Eastman, GA
  • NPI 1740272095
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation

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

{
    "created_epoch": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1275210510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2069 KINNETT RD",
            "city": "MILAN",
            "state": "GA",
            "postal_code": "310604724",
            "telephone_number": "229-860-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2069 KINNETT RD",
            "city": "MILAN",
            "state": "GA",
            "postal_code": "310604724",
            "telephone_number": "229-860-0568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-29",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN165420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodeanne Abbott, CCC-SLP
• Libby Lann
• Sheryl Marrero
• Tier One Physical Therapy LLC
• Vets M-Tec, LLC
• Mary Margaret Watkins

• Nurse Practitioner in Milan, GA
• Providers in Milan, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.