Individual provider Active NPI

Sean Patrick Kelly, ACNPC

  • Nurse Practitioner
  • Columbus, GA
National Provider Identifier
1275803108
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN-NP228991 Issued in GA
Practice address
2000 10TH Ave
Suite 270
Columbus, GA 31901-3700
Phone
(706) 571-1011
Fax
(706) 992-6595
NPI assigned
Jan 10, 2012
Last updated
Oct 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN-NP228991 GA Primary
Nurse Practitioner 363L00000X CRNP 1-114327 AL

Addresses

Primary practice location

2000 10TH Ave
Suite 270
Columbus, GA 31901-3700

Mailing address

PO Box 370
Fortson, GA 31808-0370

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
I20140102000616 GA Practitioner - Nurse Practitioner 3779742630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hughston Clinic Southeast PCGroup PAC ID 9234423971, 48 clinicians

Practice addresses (Care Compare)

2000 10TH Ave
Suite 270
Columbus, GA 31901-3706
Phone (706) 571-1011

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CRNP 1-114327ALMDNurse Practitioner
APRN-NP228991GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hughston Clinic Southeast PC CurrentSince Jan 20, 2017 Accepting new patients
Hughston Clinic Southeast PC CurrentSince Jan 20, 2017 Accepting new patients

Locations

2000 10th Ave
Ste 270
Columbus, GA 31901
Phone (706) 571-1011

6262 Veterans Pkwy
Columbus, GA 31909
Phone (706) 494-3071

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

631 Professional Dr
Ste 170
Lawrenceville, GA 30046
Phone (678) 312-2663

Interoperability endpoints

  • Direct secure messaging: sean.kelly.1@321.direct.athenahealth.com

Organizations & group practices 2

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 1

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": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1275803108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318080370",
            "fax_number": "706-221-3132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 10TH AVE",
            "address_2": "SUITE 270",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319013700",
            "telephone_number": "706-571-1011",
            "fax_number": "706-992-6595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SEAN",
        "middle_name": "PATRICK",
        "credential": "ACNPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-10",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "APRN-NP228991",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "CRNP 1-114327",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.