Keltsie S. Kellum, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

500597 Issued in NC

Practice address

317 Western Blvd
Jacksonville, NC 28546-6338

Phone

(910) 577-2240

NPI assigned

Mar 25, 2011

Last updated

Mar 25, 2011By 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 1

Addresses

Other names 1

• Keltsie M. Spivey Former name

Medicare fee-for-service enrollment

Enrolled in NC

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Johnston Pain Management PAGroup PAC ID 9931167178, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Onslow Memorial Hospital Hospital, Jacksonville, NC, CCN 340042

Merit-based Incentive Payment System (MIPS)

Final score

57.09 of 100Reported as group

Quality

57.41

Promoting interoperability

0

Improvement activities

40

Cost

82.88

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Johnston Pain Management PA

  • Specialist
  • Jacksonville, NC
  • NPI 1184705865
  Medicare reassignment Care Compare group NPD
• Tarheel Emergency Group, PLLC

  • Emergency Medicine Physician
  • Jacksonville, NC
  • NPI 1386388874
  Medicare reassignment NPD
• Emergency Coverage Services, PC

  • Nurse Practitioner
  • Lawrenceburg, TN
  • NPI 1053351593

  NC

  Medicare reassignment NPD

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

• Onslow Memorial Hospital Inc

  dba Onslow Memorial Hospital

  • General Acute Care Hospital
  • Jacksonville, NC
  • NPI 1679535496
  Care Compare affiliation

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

{
    "created_epoch": "1301011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301011200000",
    "number": "1700185006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S EVERGREEN AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080962739",
            "telephone_number": "856-686-4317",
            "fax_number": "856-848-8536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 WESTERN BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466338",
            "telephone_number": "910-577-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLUM",
        "first_name": "KELTSIE",
        "middle_name": "S.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-25",
        "last_updated": "2011-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "500597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELTSIE",
            "last_name": "SPIVEY",
            "middle_name": "M.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert E Kell, M.D
• Victoria L Kell, CNP
• Kathryn Ann Kelley, LCMHC
• Sarah E Kelley, LCSW
• Harold Field Kellogg III, LCSW
• Shyanne Kelly
• William Ferris Kelly Jr., M.D.
• Olan Baxter Kemp, M.D.
• Michele Kennedy
• Kimberly Shantale Kenny

• Family Nurse Practitioner in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; 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.