David Kelly, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN201485 Issued in GA

Practice address

101 Fornum Dr
Grovetown, GA 30813-2697

Phone

(706) 434-3500

NPI assigned

Jul 19, 2016

Last updated

Jul 19, 2016By the provider in NPPES

Sex

Male

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

Specialty

Nurse Practitioner

Education

Other, 2016

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)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment Care Compare group NPD
• Au Medical Associates Emergency Medicine Billing Services, LLC

  • Emergency Medicine Physician
  • Augusta, GA
  • NPI 1982089777
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1558714238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 FORNUM DR",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308132697",
            "telephone_number": "706-434-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 FORNUM DR",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308132697",
            "telephone_number": "706-434-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "DAVID",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-19",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN201485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Jones, PHARMD
• Melissa Mobley Jordan, D.M.D.
• Julia N. Wheeler, D.M.D, P.C. (Grovetown Family Dental)
• Carolyne Mary Kasprzak
• Amrinder Kaur, LPC
• Kiana Laniece Kelly
• William Oillie Key III, D.M.D
• Kids Elite Youth Organization (Kids Elite Learning Academy)
• Tatyana Alexzandria Rhanay Kitchen, LMSW
• Jill Wheeler Kitchens, MD

• Family Nurse Practitioner in Grovetown, GA
• Providers in Grovetown, 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 Jul 19, 2016; 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.