Individual provider Active NPI

Kelli Ann Rummings, DO

  • Pediatrics Physician
  • Augusta, GA
National Provider Identifier
1740773340
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
010053 Issued in GA
Practice address
1120 15TH St
Augusta, GA 30912-0004
Phone
(706) 721-0211
NPI assigned
Jun 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 010053 GA Primary
Pediatrics Physician 208000000X 2024-02009 NC

Addresses

Primary practice location

1120 15TH St
Augusta, GA 30912-0004

Mailing address

1120 15TH St
Augusta, GA 30912-0004

Other practice location 1

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-8092

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241205001509 NC Practitioner - Pediatric Medicine 8527308238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Campbell Univ School of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cfvhs Ed PhysiciansGroup PAC ID 2961316237, 27 clinicians

Practice addresses (Care Compare)

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-8780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2024-02009NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cfvhs Ed Physicians CurrentSince Aug 7, 2024 Accepting new patients
Cfvhs Ed Physicians Current Accepting new patients

Locations

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

Interoperability endpoints

  • Direct secure messaging: krummings127815@capefearvalley.direct-ci.com

Organizations & group practices 2

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": "1528416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1740773340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-0211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1638 Owen Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043424",
            "country_code": "US",
            "telephone_number": "910-615-8092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUMMINGS",
        "first_name": "KELLI",
        "middle_name": "ANN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-08",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "010053",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2024-02009",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.