Kelly Edwards

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN290241 Issued in GA

Practice address

305 Oak Center PL
Valdosta, GA 31602-1678

Phone

(706) 840-4671

NPI assigned

Dec 12, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southland - Lakeland Medical Services, LLCGroup PAC ID 5890947980, 5 clinicians

Southland-Nashville Emergency Services, LLC.Group PAC ID 9133390214, 7 clinicians

Southland Emergency Medical Services LLCGroup PAC ID 3779701743, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SGMC Berrien Campus Hospital, Nashville, GA, CCN 110234
• Archbold Brooks Hospital, Quitman, GA, CCN 111332
• SGMC Health Lanier Hospital, Lakeland, GA, CCN 111326

Medicare enrollment (NPD)

Enrolled

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.

• Southland - Lakeland Medical Services, LLC

  • General Acute Care Hospital
  • Lakeland, GA
  • NPI 1821341397
  Medicare reassignment Care Compare group NPD
• Southland Emergency Medical Services, L.L.C

  • Emergency Medicine Physician
  • Thomasville, GA
  • NPI 1477701472
  Medicare reassignment Care Compare group NPD
• Southland-Nashville Emergency Services, LLC.

  • Emergency Medicine Physician
  • Nashville, GA
  • NPI 1639467038
  Medicare reassignment Care Compare group NPD
• Haiti Air Ambulance

  • Air Ambulance
  • Melville, NY
  • NPI 1699536912
  NPD Authorized official
• Southland-Nashville Emergency Services, LLC

  • Hospitalist Physician
  • Nashville, GA
  • NPI 1558622266
  NPD

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

• Brooks County Hospital

  • Diagnostic Radiology Physician
  • Quitman, GA
  • NPI 1184078537

  Hospital

  Care Compare affiliation
• Brooks County Hospital

  • Critical Access Hospital
  • Quitman, GA
  • NPI 1306890942
  Care Compare affiliation
• South Georgia Medical Center Inc

  • Critical Access Hospital
  • Lakeland, GA
  • NPI 1215703632
  Care Compare affiliation
• South Georgia Medical Center Inc

  • General Acute Care Hospital
  • Nashville, GA
  • NPI 1689440091
  Care Compare affiliation

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

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1750159588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 OAK CENTER PL",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021678",
            "telephone_number": "706-840-4671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 OAK CENTER PL",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021678",
            "telephone_number": "706-840-4671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-12",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11029685",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN290241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Powella Samson Ebosa
• Sherrell Echols
• Hallie Eckdahl, MED/CCC-SLP
• Eric Brent Edgerton, MD
• Penelope Edwards-Conrad, MD
• Teaira Edwards
• William Daugharty Edwards Jr., PHARMD
• Edwin L. Lamb, D.M.D.,P.C.
• Brigita Eichler, DO
• Mahmood Sayied Eisa, MD

• Family Nurse Practitioner in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.