Kelly M Doub, NNP-BC

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

RN226465 Issued in GA

Practice address

2122 Manchester Expressway
Columbus, GA 31904

Phone

(706) 320-2773

Fax

(706) 596-4226

NPI assigned

May 20, 2011

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 2

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

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 and National Provider Directory roles.

• St. Francis Physician Practices LLC

  • Family Medicine Physician
  • Columbus, GA
  • NPI 1326749417
  Medicare reassignment NPD
• The Medical Center Inc

  • General Acute Care Hospital
  • Columbus, GA
  • NPI 1255401519
  NPD

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

{
    "created_epoch": "1305849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1700179900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 MANCHESTER EXPY STE 2001A",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046802",
            "telephone_number": "706-320-3126",
            "fax_number": "706-320-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 MANCHESTER EXPRESSWAY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31904",
            "telephone_number": "706-320-2773",
            "fax_number": "706-596-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUB",
        "first_name": "KELLY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-20",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "GA",
            "license": "RN226465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167215",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003129046E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kieondra Dorsey
• Robin Dinna Dorsey
• Julant Dorvilien, OT
• Cherilyn Doss
• Kanessa Natria Miller Doss, PHD, LAPC, NCSP, NCC
• Double Run Creek LLC
• Anthony Christopher Dougherty, M.D.
• Aisha Douglas, RBT
• Ann Douglas
• Christina Douglas, NP

• Neonatal Nurse Practitioner in Columbus, GA
• Providers in Columbus, GA by specialty
• Neonatal Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.