Kelsey Womack

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

903154 Issued in MS

Practice address

1114 Commonwealth Blvd
Tupelo, MS 38804-9301

Phone

(662) 840-6366

NPI assigned

Jan 28, 2019

Last updated

Jul 24, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Boa Vida Hospital of Aberdeen, Ms, LLC

  dba Monroe Regional Hospital

  • Multi-Specialty Clinic/Center
  • Aberdeen, MS
  • NPI 1710405741
  Medicare reassignment NPD
• Boa Vida Hospital of Aberdeen, Ms LLC

  dba MRH Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Aberdeen, MS
  • NPI 1134858269
  NPD
• Sanctuary Hospice House, Inc

  • Community Based Hospice Care Agency
  • Tupelo, MS
  • NPI 1659392645

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1548633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1679037279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 COMMONWEALTH BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388049301",
            "telephone_number": "662-840-6366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 COMMONWEALTH BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388049301",
            "telephone_number": "662-840-6366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOMACK",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-28",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MS",
            "license": "903154",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "903154",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE",
            "identifier": "903154",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Claire Wiygul, CFNP
• Wmob Health Transit LLC
• Thomas Angelo Wohlwender
• Kenneth Wolfe, MD
• Bradley Gerald Womack, MD
• Womfroe Homecare LLC
• Alison Wood, OTR/L
• Greg Lynn Wood, RPH
• Haley Jordyn Wood, M.A., BCBA
• Leslie Wood

• Primary Care Nurse Practitioner in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Primary Care Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.