Penny Kelly, APRN

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

R864313 Issued in MS

Practice address

2500 N State St
Jackson, MS 39216-4500

Phone

(601) 984-5650

Fax

(601) 984-5658

NPI assigned

Sep 25, 2013

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Foundation of Central Mississippi IncGroup PAC ID 1153216411, 274 clinicians

Mississippi Physicians LLPGroup PAC ID 7113193855, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102

Merit-based Incentive Payment System (MIPS)

Final score

78.38 of 100Reported as group

Quality

54.22

Promoting interoperability

100

Improvement activities

40

Cost

73.72

Merit-based Incentive Payment System (MIPS)

Final score

89.9 of 100Reported as group

Quality

80.75

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pkelly25288@ummc.direct-ci.com
• Direct secure messaging: pkelly368722@direct.bmhcc.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.

• Medical Foundation of Central Mississippi, Inc.

  dba Baptist Medical Clinics

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1992774814
  Medicare reassignment Care Compare group NPD
• Mississippi Physicians LLP

  • Emergency Medicine Physician
  • Corinth, MS
  • NPI 1902174832
  Medicare reassignment Care Compare group NPD
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment NPD
• Medical Foundation of Central Ms

  dba Baptist Medical Clinic-Brandon

  • Family Medicine Physician
  • Brandon, MS
  • NPI 1114264264
  NPD
• Mississippi Physicians, LLP

  • Emergency Medicine Physician
  • Jackson, MS
  • NPI 1982011714
  NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD

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

• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585
  Care Compare affiliation

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585180800000",
    "number": "1598191298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5650",
            "fax_number": "601-984-5658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-5650",
            "fax_number": "601-984-5658"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392022064",
            "country_code": "US",
            "telephone_number": "601-988-5281",
            "fax_number": "601-972-6241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "PENNY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-25",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "R864313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05824748",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Levella Kelly, PTA
• Mick Henry Kelly
• Morgan Kelly, MD
• Ophelia Kelly, L.P.C.
• Peggy L Kelly
• Shenika Sharee Kelly
• Jeannie N Kelso, LCSW
• David Wayne Kelton, M.D.
• Kemet Health One LLC
• Ann Butler Kemp, MD

• Acute Care Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Acute Care Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; 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.