Dustin Kelly, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

930879 Issued in MS

Practice address

1915 Lindsay Rd
Lena, MS 39094-9296

Phone

(601) 572-9320

NPI assigned

Jul 29, 2026

Last updated

Sep 27, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• First-Line LLC

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  Authorized official Same address or phone

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

{
    "created_epoch": "1785283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790467200000",
    "number": "1851213839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 LINDSAY RD",
            "city": "LENA",
            "state": "MS",
            "postal_code": "390949296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 LINDSAY RD",
            "city": "LENA",
            "state": "MS",
            "postal_code": "390949296",
            "telephone_number": "601-572-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "DUSTIN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-07-29",
        "last_updated": "2026-09-27",
        "certification_date": "2026-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LS0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, School",
            "state": "MS",
            "license": "NA",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "930879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janaisha Berry, NP
• Rebecca Annette Johnston, FNP-C
• Lena Family Medical, Inc.
• Magnolia Recreation and Services LLC
• Brett Chapin Moore, PHARMD
• Itanjula Moore
• Moore's Pharmacy Lena LLC

• Registered Nurse in Lena, MS
• Providers in Lena, MS by specialty
• Registered Nurse in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.