Individual provider Active NPI

Kelli Wilkinson

  • Adult Health Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1891366787
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
30012 Issued in SC
Practice address
200 Patewood Dr Ste B260
Greenville, SC 29615-6328
Phone
(864) 454-2852
Fax
(864) 454-2899
NPI assigned
Jul 1, 2021
Last updated
Apr 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.0029188 OH
Gerontology Nurse Practitioner 363LG0600X APRN.CNP.0029188 OH
Adult Health Nurse Practitioner 363LA2200X 30012 SC Primary

Addresses

Primary practice location

200 Patewood Dr Ste B260
Greenville, SC 29615-6328

Mailing address

300 E McBee Ave Ste 300
Greenville, SC 29601-2899
Phone (864) 522-8611

Other practice location 1

1044 Belmont Ave
Youngstown, OH 44504-1006
Phone (330) 480-2040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210813001344 OH Practitioner - Nurse Practitioner 2163826082 Reassigns benefits to 2 organizations
I20250321003404 SC Practitioner - Nurse Practitioner 2163826082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Omni Dr
Suite a
Seneca, SC 29672-9448
Phone (864) 885-7520

102 B Omni Dr
Seneca, SC 29672-9448
Phone (864) 885-7971

103 Omni Dr
Suite B
Seneca, SC 29672-9448
Phone (864) 886-9250

105 B Omni Dr
Seneca, SC 29672-9448
Phone (864) 482-3157

107 Omni Dr
Suite a
Seneca, SC 29672-9448
Phone (864) 885-7475

109 Omni Dr
Suite B
Seneca, SC 29672-9448
Phone (864) 888-4222

200 Patewood Dr
Suite C300
Greenville, SC 29615-6324
Phone (864) 454-8272

210 Freeman Farm Rd
Duncan, SC 29334-9398
Phone (864) 968-5123

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
30012SCMDInternal Medicine Physician
APRN.CNP.0029188OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Apr 21, 2025 Accepting new patients
Prisma Health University Medical Group CurrentSince Apr 21, 2025 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince Oct 23, 2022 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC Nurse Practitioner CurrentSince Oct 23, 2022 Accepting new patients
Pulmonary Rehabilitation Associates CurrentSince Sep 1, 2021 Accepting new patients

Locations

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

667 Eastland Ave SE
Warren, OH 44484
Phone (330) 841-2378

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

925 Trailwood Dr
Youngstown, OH 44512
Phone (330) 758-7575

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

200 Patewood Dr
Ste B260
Greenville, SC 29615
Phone (864) 454-2100

200 Patewood Dr
Ste C300
Greenville, SC 29615
Phone (864) 454-2852

300 E McBee Ave
Ste 300
Greenville, SC 29601

103 Omni Dr
#B
Seneca, SC 29672
Phone (864) 482-3285

Interoperability endpoints

  • Direct secure messaging: kwilkinson843761@direct.ghs.myhfn.org

Organizations & group practices 5

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1891366787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012899",
            "telephone_number": "864-522-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR STE B260",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156328",
            "telephone_number": "864-454-2852",
            "fax_number": "864-454-2899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1044 Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445041006",
            "country_code": "US",
            "telephone_number": "330-480-2040",
            "fax_number": "330-480-2071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKINSON",
        "first_name": "KELLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0029188",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "APRN.CNP.0029188",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "30012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.