Dustin Kelly, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

906082 Issued in MS

Practice address

1117 Sunset Dr Ste 101
Grenada, MS 38901-4080

Phone

(662) 226-1168

NPI assigned

Jul 4, 2023

Last updated

Jul 4, 2023By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Joseph F Roberts MD PAGroup PAC ID 7012942253, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Accentcare Home Health of Greenwood Home health agency, Greenwood, MS, CCN 257131
• University of Mississippi Medical Center- Grenada Hospital, Grenada, MS, CCN 250168
• Tyler Holmes Memorial Hospital Cah Hospital, Winona, MS, CCN 251312

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24236/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir-myrecord.cerner.com/r4/8ae75827-0f9b-457f-be6b-a17f2d896c19/

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.

• Joseph F Roberts MD PA

  • Internal Medicine Physician
  • Grenada, MS
  • NPI 1629269709
  Medicare reassignment Care Compare group NPD
• Stanford Medical Inc

  • Family Medicine Physician
  • Grenada, MS
  • NPI 1811201544
  NPD

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

• Sta-Home Health Agency of Greenwood, Inc.

  dba AccentCare Home Health of Greenwood

  • Home Health Agency
  • Greenwood, MS
  • NPI 1235270588
  Care Compare affiliation
• State of Mississippi-University of Mississippi Medical Center

  dba University of Mississippi Center - Grenada Psych

  • Psychiatric Hospital
  • Grenada, MS
  • NPI 1083041917
  Care Compare affiliation
• State of Mississippi-University of Mississippi Medical Center

  dba University of Mississippi Center-Grenada

  • General Acute Care Hospital
  • Grenada, MS
  • NPI 1558798603
  Care Compare affiliation
• Tyler Holmes Memorial Hospital

  • Critical Access Hospital
  • Winona, MS
  • NPI 1205868627
  Care Compare affiliation

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

{
    "created_epoch": "1688428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688428800000",
    "number": "1942987664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 COUNTY ROAD 240",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389306995",
            "telephone_number": "662-299-5796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 SUNSET DR STE 101",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389014080",
            "telephone_number": "662-226-1168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "DUSTIN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-04",
        "last_updated": "2023-07-04",
        "certification_date": "2023-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906082",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "899168",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• K Squared, Inc. (Kringle Dentistry)
• Karen Plunkett, M.D.PC
• Kasp Consulting Inc
• Lewis Wesley Keen Jr., MSN CRNA
• Mark C Kelley, DO
• Joby Garrard Kelly, CFNP
• Kgi, LLC
• Kilmichael Medical Suppliers (InHealth Medical Suppliers)
• Jason Guynes King, PTA
• Andrea Platz Kinniburgh, PHARMD

• Family Nurse Practitioner in Grenada, MS
• Providers in Grenada, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2023; 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.