Janet Kelly
Individual provider Active NPI Family Nurse Practitioner · Carthage, MS
NPI 1396252011 · NPPES record last updated Mar 20, 2022
Key facts
- NPI
- 1396252011
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- F12170203 (MS)
- Practice address
- 1071 E Franklin St
Carthage, MS 39051-3601 - Phone
- (601) 267-4562
- Fax
- (601) 267-4589
- NPI assigned
- Jan 3, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 8
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Minor Med Care, LLC
MDB Behavioral Health Services LLC
Practice addresses (Care Compare)
120 W Main St
Raymond, MS 39154-1223
Phone (601) 857-2341
1911 Mission
66 Suite B
Vicksburg, MS 39180-3762
Phone (601) 456-2598
Hospital & facility affiliations
- Baptist Medical Center-Leake
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180802002120 | MS | Practitioner - Nurse Practitioner | 3678821972 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F12170203 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MDB Behavioral Health Services LLC | Current |
Accepting new patients | |
| MDB Care Management LLC | Current |
Accepting new patients | |
| Minor Med Care, LLC | Current |
Accepting new patients | |
| Minor Med Care, LLC | Current |
Accepting new patients | |
| Southern Medical Consultants LLC | Current |
Accepting new patients | |
| Uppal Medical Center LLC | Current |
Accepting new patients | |
| Madden Medical Clinic LLC | Past |
Accepting new patients | |
| Vytalize Health | Past |
Accepting new patients |
Locations
108 Four LN Hwy 49
Bentonia, MS 39040
Phone (662) 998-8900
1727 E Union St
Greenville, MS 38703
Phone (662) 332-0373
215 Katherine Dr
#A
Jackson, MS 39232
2860 McDowell Road Ext
Jackson, MS 39204
Phone (601) 372-1117
7048 Old Canton Rd
Ste 2E
Ridgeland, MS 39157
Phone (601) 919-0972
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F12170203 | MS | Yes |
Addresses
Primary practice location
1071 E Franklin St
Carthage, MS 39051-3601
Mailing address
1071 E Franklin St
Carthage, MS 39051-3601
Phone (601) 267-4562
Other providers in Carthage, MS
- Jordan Tyler Jackson
- Amanda Jones Mitchell
- Anya Jones
- Tommy G. Jones, D.D.S., PLLC
- Tommie K Jones
- KW Registered Dietitian Nutritionist P.L.L.C.
- Charlotte Rena Laster
- Jessica Sharleen Lavender
- Leake County Board of Trustees
- Leake County School District
All providers in Carthage, MS · Family Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.