Kelly Brumbelow Nix, FNP, BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN112048 Issued in GA

Practice address

145 N Medical Pkwy
Woodstock, GA 30189

Phone

(770) 592-3000

Fax

(770) 999-2650

NPI assigned

Jul 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kelly D. Brumbelow Former name

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, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: knix26300@directwellstar.org

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.

• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003

  GA

  Medicare reassignment Care Compare group NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  Care Compare group
• Wellstar Medical Group, LLC

  • Otolaryngology Physician
  • Marietta, GA
  • NPI 1881990455
  NPD

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

• Kennestone Hospital, Inc.

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1386659928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 N MEDICAL PKWY",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301897031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 N MEDICAL PKWY",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "30189",
            "telephone_number": "770-592-3000",
            "fax_number": "770-999-2650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3825 Medical Park Dr",
            "address_2": "Ste 201",
            "address_purpose": "LOCATION",
            "city": "Austell",
            "state": "GA",
            "postal_code": "301066831",
            "country_code": "US",
            "telephone_number": "770-941-8100",
            "fax_number": "770-948-0771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIX",
        "first_name": "KELLY",
        "middle_name": "BRUMBELOW",
        "name_prefix": "Mrs.",
        "credential": "FNP, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "112048",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN112048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "316257111A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "BRUMBELOW",
            "middle_name": "D.",
            "credential": "FNP, BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julie Tierney Nicholson, M.D.
• Kimberly Marie Nicholson, M.D.
• Daniel Mark Niederjohn, PH.D.
• Katerina Nikolova
• Melanie Jayne Nimmo, LPCC
• Sharon R. Nix, LPC
• Noah'S Ark Youth and Family Services LLC
• Reginald Noel
• Chhavi V Noohani, DO
• Penny Nordin, M.A., CCC/SLP

• All providers in Woodstock, GA
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.