Kelly McCollum Pendleton, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN191030 Issued in GA

Practice address

3702 2ND Ave
Columbus, GA 31904-7408

Phone

(706) 507-9209

NPI assigned

Dec 16, 2024

Last updated

Dec 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.pendleton.1@8710.direct.athenahealth.com

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.

• Mercymed of Columbus Inc

  • Internal Medicine Physician
  • Columbus, GA
  • NPI 1639450877
  Medicare reassignment NPD

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1437966108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 GRIZZLY CT",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318084556",
            "telephone_number": "706-577-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 2ND AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319047408",
            "telephone_number": "706-507-9209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDLETON",
        "first_name": "KELLY",
        "middle_name": "MCCOLLUM",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN191030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanner Donald Peebles, DO
• David O Peed, O. D.
• Virginia Cole Peek, DMD
• Kelly Kathleen Peledge, NP
• Stephen E Pellegrin, CRNA
• Brandon Penick
• Jessica Yvette Penn
• Samuel Pennell, CRNA
• Rachael Elise Pennock, AUD
• Vivian Perez-Marshall

• Family Nurse Practitioner in Columbus, GA
• Providers in Columbus, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.