Beverly Shelley Kelly, FNP
Individual provider Active NPI Nurse Practitioner · Arley, AL
NPI 1609242577 · NPPES record last updated Jan 27, 2025
Key facts
- NPI
- 1609242577
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 1-181005 (AL)
- Practice address
- 614 Paradise Way
Arley, AL 35541-0150 - Phone
- (678) 343-5302
- NPI assigned
- Aug 14, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- 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 |
|---|---|---|---|---|
| I20221110001111 | AL | Practitioner - Nurse Practitioner | 5395034516 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-181005 | AL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signify Health, LLC | Nurse Practitioner | Current |
Accepting new patients |
Locations
4000 Eagle Point Corporate Dr
Birmingham, AL 35242
Phone (205) 317-0280
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1-181005 | AL | Yes |
Addresses
Primary practice location
614 Paradise Way
Arley, AL 35541-0150
Mailing address
614 Paradise Way
Arley, AL 35541-0150
Phone (678) 343-5302
Other providers in Arley, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2025. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.