Kelli Stewart, FNP-BC
Individual provider Active NPI Nurse Practitioner · Macon, MS
NPI 1790665495 · NPPES record last updated Sep 3, 2025
Key facts
- NPI
- 1790665495
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 907732 (MS)
- Practice address
- 222 Lindley Rd
Macon, MS 39341-8846 - Phone
- (601) 613-9393
- NPI assigned
- Sep 3, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Noxubee General Critical Access Hospital
Practice addresses (Care Compare)
78 Hospital Rd
Macon, MS 39341-2490
Phone (662) 726-4231
Hospital & facility affiliations
- Noxubee General Critical Access Hosp
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260120000308 | MS | Practitioner - Nurse Practitioner | 5496232670 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 907732 | MS | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Noxubee General Critical Access Hospital | Current |
Accepting new patients | |
| Noxubee General Critical Access Hospital | Current |
Accepting new patients | |
| Noxubee General Critical Access Hospital | Past | Accepting new patients | |
| Brooksville Medical Clinic Inc | Past | Accepting new patients |
Locations
78 Hospital Rd
Ste 1
Macon, MS 39341
3878 Jefferson St
Macon, MS 39341
Phone (601) 726-5831
78 Hospital Rd
#1
Macon, MS 39341
78 Hospital Rd
Macon, MS 39341
Phone (662) 726-4231
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 907732 | MS | Yes |
Addresses
Primary practice location
222 Lindley Rd
Macon, MS 39341-8846
Mailing address
222 Lindley Rd
Macon, MS 39341-8846
Phone (601) 613-9393
Other providers in Macon, MS
- Cheyanne Simpson
- Keeli Donyae Smith
- Rico Smith
- Steven Gregory Spurgeon
- Lakisha Stevenson
- Tashana Stovall
- Brittnay Tate
- Kristin Miller Tawater
- Trinity Mobile Health Clinic
- Trinity Specialty Care Services, Inc
All providers in Macon, MS · Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.