Kelly A Greene, FNP – Family Nurse Practitioner

Key facts

NPI: 1831968437
Entity type: Individual (NPI type 1)
Primary specialty: Family Nurse Practitioner 363LF0000X
License: GAA-NP001940 (GA)
Practice address: 638 Old Historic US 441
Suite B
Demorest, GA 30535
Phone: (770) 501-3830
NPI assigned: Dec 22, 2023
Sex: Female
Sole proprietor: No

Organizations & group practices 2

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.

Georgia Heart Institute LLC Cardiovascular Disease Physician · Gainesville, GA · NPI 1477976520

Medicare reassignment Care Compare group NPD GA
Northeast Georgia Heart Center Cardiovascular Disease Physician · Gainesville, GA · NPI 1508812421

NPD

Hospital & facility affiliations 2

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 Hospital
Northeast Georgia Medical Center, Inc. General Acute Care Hospital · Gainesville, GA · NPI 1427055821

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Nurse Practitioner
Education: Other, 2023
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Georgia Heart Institute LLC (127 clinicians)

Practice addresses (Care Compare)

638 Old Historic US 441 B
Demorest, GA 30535-4561
Phone (770) 534-2020

Hospital & facility affiliations

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

Medicare participation

Medicare fee-for-service enrollment: Enrolled in GA
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
I20240124001900	GA	Practitioner - Nurse Practitioner	8224481445	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
GAA-NP001940	GA	MD	Family Nurse Practitioner

Practice roles

Organization	Specialty	Status	New patients
Northeast Georgia Heart Center		Current	Accepting new patients
Georgia Heart Institute LLC		Current since Jan 17, 2024	Accepting new patients

Locations

638 441 Historic Hwy N
Ste B
Demorest, GA 30535
Phone (706) 754-8339

200 S Enota Dr NE
Ste 200
Gainesville, GA 30501
Phone (770) 534-0991

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Nurse Practitioner	363LF0000X	GAA-NP001940	GA	Yes

Addresses

Primary practice location

638 Old Historic US 441
Suite B
Demorest, GA 30535

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other providers in Demorest, GA

All providers in Demorest, GA · Family Nurse Practitioner in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2024. 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.

Verify at the official NPI Registry.