Active NPI
Keely Radcliff Paramo
- Women's Health Nurse Practitioner
- Moultrie, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- RN176734
- Practice address
- 115 31St Ave SE
Moultrie, GA 31768-6771 - Phone
- (229) 502-7988
- Fax
- (229) 890-2166
- NPI assigned
- Sep 20, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | RN176734 | GA | Primary |
Addresses
Primary practice location
115 31St Ave SE
Moultrie, GA 31768-6771
Mailing address
PO Box 2876
Moultrie, GA 31776-2876
Phone (229) 502-9788
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
115 31St Ave SE
Moultrie, GA 31768-6771
Phone (229) 502-1020
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Urogynecology & Pelvic Surgery LLC | Current | Accepting new patients | |
| Southern Pelvic Therapy LLC | Current | Accepting new patients |
Locations
115 31st Ave SE
Moultrie, GA 31768
Phone (229) 502-1020
3131 Thomasville Hwy
Moultrie, GA 31768
Phone (229) 502-9769
403 Cowart Ave
Valdosta, GA 31602
Phone (229) 244-0034
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 and National Provider Directory roles.
-
dba Sterling Group Urogynecology & Pelvic Surgery
- Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
- Moultrie, GA
- NPI 1174154421
-
- Physical Therapist
- Moultrie, GA
- NPI 1780579045
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Moultrie, GA
- NPI 1912099094
-
dba Colquitt Regional Geriatric Behavioral Health
- Psychiatric Hospital Unit
- Moultrie, GA
- NPI 1982295036
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757289600000",
"number": "1306663455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2876",
"city": "MOULTRIE",
"state": "GA",
"postal_code": "317762876",
"telephone_number": "229-502-9788",
"fax_number": "229-891-2166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 31ST AVE SE",
"city": "MOULTRIE",
"state": "GA",
"postal_code": "317686771",
"telephone_number": "229-502-7988",
"fax_number": "229-890-2166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARAMO",
"first_name": "KEELY",
"middle_name": "RADCLIFF",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-20",
"last_updated": "2025-09-08",
"certification_date": "2025-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "GA",
"license": "RN176734",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Moultrie, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.