Individual provider Active NPI

Meghan Kelley, FNP

  • Family Nurse Practitioner
  • Jesup, GA
National Provider Identifier
1750130902
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN302899 Issued in GA
Practice address
125 Memorial Dr Ste a
Jesup, GA 31545-0134
Phone
(912) 559-2337
NPI assigned
May 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN302899 GA Primary

Addresses

Primary practice location

125 Memorial Dr Ste a
Jesup, GA 31545-0134

Mailing address

3425 Nellie St
Patterson, GA 31557-5090

Other practice location 1

228 Memorial Dr
Jesup, GA 31545-0102
Phone (912) 559-2432

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241031000202 GA Practitioner - Nurse Practitioner 6507399417 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wayne SJC Medical Group LLCGroup PAC ID 5496901811, 10 clinicians

Practice addresses (Care Compare)

125 Memorial Dr
Suite a
Jesup, GA 31545-0124
Phone (912) 427-7790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN302899GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Health Network LLC CurrentSince Nov 1, 2025 Accepting new patients
Wayne SJC Medical Group, LLC CurrentSince Nov 1, 2024 Accepting new patients
Wayne SJC Medical Group, LLC CurrentSince Nov 1, 2024 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

1000 Parkwood Cir SE
Ste 900
Atlanta, GA 30339
Phone (216) 393-8684

111 Colonial Way
Ste 3
Jesup, GA 31545
Phone (912) 427-8365

930 S 1st St
Jesup, GA 31545
Phone (912) 385-2702

320 Peachtree St
Jesup, GA 31545
Phone (912) 521-8039

230 Memorial Dr
Jesup, GA 31545
Phone (478) 427-8418

125 Memorial Dr
Ste A
Jesup, GA 31545
Phone (912) 559-2337

228 Memorial Dr
Jesup, GA 31545
Phone (912) 530-6582

865 S 1st St
Jesup, GA 31545
Phone (912) 427-6811

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDDICA

Organizations & group practices 3

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": "1715904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1750130902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 NELLIE ST",
            "city": "PATTERSON",
            "state": "GA",
            "postal_code": "315575090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 MEMORIAL DR STE A",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450134",
            "telephone_number": "912-559-2337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "228 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Jesup",
            "state": "GA",
            "postal_code": "315450102",
            "country_code": "US",
            "telephone_number": "912-559-2432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "MEGHAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-17",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN302899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jesup, GA

Sources for this page

Verify at the official NPI Registry.