Kelly Diane McCarley

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

RN219753 Issued in GA

Practice address

1908 Tarver Dr
Blakely, GA 39823-1540

Phone

(229) 308-0460

NPI assigned

Sep 14, 2018

Last updated

Sep 14, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoebe Physician Group IncGroup PAC ID 8426112350, 420 clinicians

The Hospital Authority of Miller CountyGroup PAC ID 0244224947, 30 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phoebe Putney Memorial Hospital Hospital, Albany, GA, CCN 110007
• Phoebe Sumter Medical Center Hospital, Americus, GA, CCN 110044

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.mccarley.1@8478.direct.athenahealth.com
• Direct secure messaging: kelly.mccarley@phoebehealth.gadirect.net

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.

• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment Care Compare group NPD
• The Hospital Authority of Miller County

  • Critical Access Hospital
  • Colquitt, GA
  • NPI 1710105119
  Medicare reassignment Care Compare group
• The Hospital Authority of Miller County

  • Medicare Defined Swing Bed Hospital Unit
  • Colquitt, GA
  • NPI 1285794750
  NPD
• The Hospital Authority of Miller County

  dba Calhoun Nursin Home

  • Skilled Nursing Facility
  • Edison, GA
  • NPI 1649353111
  NPD
• The Hospital Authority of Miller County

  dba Miller Nursing Home

  • Skilled Nursing Facility
  • Colquitt, GA
  • NPI 1760540850
  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)

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

• Phoebe Putney Memorial Hospital Inc

  dba Phoebe Putney Memorial Hosptial

  • General Acute Care Hospital
  • Albany, GA
  • NPI 1992789721
  Care Compare affiliation
• Phoebe Sumter Medical Center, Inc.

  • General Acute Care Hospital
  • Americus, GA
  • NPI 1609001312
  Care Compare affiliation

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1649753773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 TARVER DR",
            "city": "BLAKELY",
            "state": "GA",
            "postal_code": "398231540",
            "telephone_number": "229-308-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 TARVER DR",
            "city": "BLAKELY",
            "state": "GA",
            "postal_code": "398231540",
            "telephone_number": "229-308-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARLEY",
        "first_name": "KELLY",
        "middle_name": "DIANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-14",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "GA",
            "license": "RN219753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifebrite Hospital Group of Early LLC
• Lifebrite Hospital Group of Early LLC (Early EMS)
• Lifebrite Hospital Group, LLC
• Nicholas James Long
• Elizabeth Singletary Mansfield, FNP-C
• Penelope Leigh McDonald, LPC
• Medicomp, Inc. (Medicomp Physical Therapy Blakely)
• Donna Lashawn Mells-McCoy
• Mike's Pharmacy, Inc
• Michelle Mock, RN

• Gerontology Nurse Practitioner in Blakely, GA
• Providers in Blakely, GA by specialty
• Gerontology Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2018; 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.