Active NPI
Kelly Metts Humphries, APRN
- Family Nurse Practitioner
- Moncks Corner, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APN28247RX
- Practice address
- 1043 Black Tom Rd
Moncks Corner, SC 29461-8816 - Phone
- (843) 860-7535
- NPI assigned
- Jan 29, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 28247 | SC | |
| Occupational Health Nurse Practitioner | 363LX0106X | APN28247RX | SC | |
| Family Nurse Practitioner | 363LF0000X | APN28247RX | SC | Primary |
Addresses
Primary practice location
1043 Black Tom Rd
Moncks Corner, SC 29461-8816
Mailing address
1043 Black Tom Rd
Moncks Corner, SC 29461-8816
Phone (843) 860-7535
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APN28247RX | SC | MD | Occupational Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Family Care | Current | Accepting new patients | |
| Carolina Family Care, Inc | Current | Accepting new patients | |
| Musc Community Physicians | Current | Accepting new patients | |
| Musc Community Physicians | Current | Accepting new patients | |
| Novant Health Urgent Cares LLC | Current | Accepting new patients | |
| Carolina Family Care, Inc | Past | Accepting new patients |
Locations
6167 Braided Mane Pass SW
Aiken, SC 29803
Phone (803) 502-1484
506 North St
Bamberg, SC 29003
Phone (803) 245-6290
169 Ashley Ave
Charleston, SC 29425
Phone (843) 792-3072
459 N Highway 52
Moncks Corner, SC 29461
Phone (843) 889-3870
1208 Two Island Ct
Mt Pleasant, SC 29466
Phone (843) 884-6653
200 Ports Authority Dr
Mt Pleasant, SC 29464
Phone (843) 876-1560
2475 Broad St
Sumter, SC 29150
Phone (803) 778-6555
Interoperability endpoints
- kellis533673@direct.musc.edu
Organizations & group practices 6
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.
-
- Family Medicine Physician
- Charleston, SC
- NPI 1184655722
-
- Internal Medicine Physician
- Bamberg, SC
- NPI 1841878006
-
- Urgent Care Clinic/Center
- Anderson, SC
- NPI 1841026382
-
- Family Medicine Physician
- Mount Pleasant, SC
- NPI 1669743357
-
- Rural Health Clinic/Center
- Bowman, SC
- NPI 1225735772
-
- Pediatrics Physician
- Charleston, SC
- NPI 1750318101
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773792000000",
"number": "1821850447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1043 BLACK TOM RD",
"city": "MONCKS CORNER",
"state": "SC",
"postal_code": "294618816",
"telephone_number": "843-860-7535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1043 BLACK TOM RD",
"city": "MONCKS CORNER",
"state": "SC",
"postal_code": "294618816",
"telephone_number": "843-860-7535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUMPHRIES",
"first_name": "KELLY",
"middle_name": "METTS",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-29",
"last_updated": "2026-03-18",
"certification_date": "2026-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "SC",
"license": "28247",
"primary": false
},
{
"code": "363LX0106X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Occupational Health",
"state": "SC",
"license": "APN28247RX",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "SC",
"license": "APN28247RX",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Moncks Corner, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.