Individual provider Active NPI

Kelly Layton Weldon, FNP-C

  • Family Nurse Practitioner
  • Destin, FL
National Provider Identifier
1790532885
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN278261 Issued in GA
Practice address
36474 Emerald Coast Pkwy Ste C
Destin, FL 32541-4711
Phone
(404) 852-7658
NPI assigned
May 6, 2024
Last updated
Sep 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X RN278261 GA Primary
Family Nurse Practitioner 363LF0000X APRN11039540 FL

Addresses

Primary practice location

36474 Emerald Coast Pkwy Ste C
Destin, FL 32541-4711

Mailing address

455 Philip Blvd Ste 140
Lawrenceville, GA 30046-8768
Phone (770) 962-3642

Other practice location 1

7414 Hodgson Memorial Dr Ste A
Savannah, GA 31406-2582
Phone (770) 962-3642

Other names 1

  • Kelly Layton Green Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250215000084 GA Practitioner - Nurse Practitioner 6002346343 Reassigns benefits to 1 organization
I20260401004188 FL Practitioner - Nurse Practitioner 6002346343 Reassigns benefits to 1 organization

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
Atwood and Clark Associates, LLCGroup PAC ID 1557683521, 5 clinicians

Practice addresses (Care Compare)

201 Forest Park Cir
Panama City, FL 32405-4916
Phone (850) 248-7779

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11039540FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Pain and Wellness Center Single Specialty CurrentSince Nov 7, 2024 Accepting new patients
Georgia Pain and Wellness Center Single Specialty CurrentSince Nov 7, 2024 Accepting new patients

Locations

455 Philip Blvd
Ste 140
Lawrenceville, GA 30046
Phone (787) 618-5889

7414 Hodgson Memorial Dr
Ste A
Savannah, GA 31406

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1790532885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 PHILIP BLVD STE 140",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468768",
            "telephone_number": "770-962-3642",
            "fax_number": "770-962-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36474 EMERALD COAST PKWY STE C",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325414711",
            "telephone_number": "404-852-7658"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7414 Hodgson Memorial Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314062582",
            "country_code": "US",
            "telephone_number": "770-962-3642",
            "fax_number": "770-962-3643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELDON",
        "first_name": "KELLY",
        "middle_name": "LAYTON",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-06",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN278261",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11039540",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "GREEN",
            "middle_name": "LAYTON",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Destin, FL

Sources for this page

Verify at the official NPI Registry.