Kelly A Greene, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

GAA-NP001940 Issued in GA

Practice address

638 Old Historic US 441
Suite B
Demorest, GA 30535

Phone

(770) 501-3830

NPI assigned

Dec 22, 2023

Last updated

Jan 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Georgia Heart Institute LLCGroup PAC ID 4183848062, 127 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeast Georgia Medical Center Habersham Hospital, Demorest, GA, CCN 110041
• Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029

Medicare enrollment (NPD)

Enrolled

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

• Georgia Heart Institute LLC

  • Cardiovascular Disease Physician
  • Gainesville, GA
  • NPI 1477976520
  Medicare reassignment Care Compare group NPD
• Northeast Georgia Heart Center

  • Cardiovascular Disease Physician
  • Gainesville, GA
  • NPI 1508812421
  NPD

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

• Northeast Georgia Medical Center Habersham LLC

  • General Acute Care Hospital
  • Demorest, GA
  • NPI 1740981430
  Care Compare affiliation
• Northeast Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, GA
  • NPI 1427055821
  Care Compare affiliation

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

{
    "created_epoch": "1703203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1831968437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 OLD HISTORIC US 441",
            "address_2": "SUITE B",
            "city": "DEMOREST",
            "state": "GA",
            "postal_code": "30535",
            "telephone_number": "770-501-3830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "KELLY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-22",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "GAA-NP001940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ravinderpal K Gill, M.D.
• Donna M Glaser, LPN
• Katherine Glenn, PTA
• Kristen Sills Gosnell, FNP-C
• Courtney Lee Green, FNP-C
• Jonathan C Griggs, CRNA
• Benjamin Thomas Griswold, LMSW
• Finda L Guyton, MD
• Habersham Anesthesia Associates
• Habersham County Health Department

• Family Nurse Practitioner in Demorest, GA
• Providers in Demorest, 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 Jan 4, 2024; 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.