Individual provider Active NPI

Kelly McLemore, NP-C

  • Family Nurse Practitioner
  • Nevada, MO
National Provider Identifier
1609298090
Registry record updated Jan 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2014000701 Issued in MO
Practice address
900 S Adams St
Nevada, MO 64772-3210
Phone
(417) 667-6015
NPI assigned
Jan 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2014000701 MO Primary

Addresses

Primary practice location

900 S Adams St
Nevada, MO 64772-3210

Mailing address

900 S Adams St
Nevada, MO 64772-3210
Phone (417) 667-6015

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251210004517 GA Practitioner - Nurse Practitioner 7911139167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4300 N Point Pkwy
Suite 300
Alpharetta, GA 30022-4102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Medical Group, P.C. CurrentSince Dec 8, 2025 Accepting new patients

Locations

1255 Friendship Rd
Ste 130
Braselton, GA 30517
Phone (678) 341-6350

106 Briarwood Rd
Statesboro, GA 30458
Phone (912) 871-5000

1555 Brampton Ave
Statesboro, GA 30458
Phone (912) 243-9299

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1390176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390176000000",
    "number": "1609298090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S ADAMS ST",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647723210",
            "telephone_number": "417-667-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S ADAMS ST",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647723210",
            "telephone_number": "417-667-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEMORE",
        "first_name": "KELLY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-20",
        "last_updated": "2014-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2014000701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nevada, MO

Sources for this page

Verify at the official NPI Registry.