Kelly Williams Rydell, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

27403 Issued in SC

Practice address

1740 Highway 160 W
Fort Mill, SC 29708-8025

Phone

(866) 389-2727

NPI assigned

Sep 6, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Kelly Lianne Williams Former name

Medicare fee-for-service enrollment

Enrolled in SC, VA, DC, NC4 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 4

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minuteclinic Diagnostic South Carolina LLCGroup PAC ID 8527126861, 113 clinicians

Minuteclinic Diagnostic of North Carolina PCGroup PAC ID 6002837572, 208 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

82.87 of 100Reported as group

Quality

79.98

Improvement activities

40

Cost

79.6

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

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.

• Minuteclinic Diagnostic South Carolina LLC

  • Family Nurse Practitioner
  • Simpsonville, SC
  • NPI 1447420815
  Medicare reassignment Care Compare group NPD
• Minuteclinic Diagnostic of North Carolina PC

  • Family Nurse Practitioner
  • Raleigh, NC
  • NPI 1699748608
  Medicare reassignment Care Compare group NPD
• Minuteclinic Primary Care South Carolina LLC

  • Family Nurse Practitioner
  • Simpsonville, SC
  • NPI 1548070071
  Medicare reassignment NPD
• Minuteclinic Diagnostic of Virginia LLC

  • Family Nurse Practitioner
  • Leesburg, VA
  • NPI 1417076829

  DC

  Medicare reassignment NPD
• Minuteclinic Primary Care - Virginia PLLC

  • Family Nurse Practitioner
  • Leesburg, VA
  • NPI 1275341620

  DC

  Medicare reassignment NPD
• Minuteclinic Video Virtual Care, PLLC

  • Family Nurse Practitioner
  • Woonsocket, RI
  • NPI 1316402746

  SC

  Medicare reassignment NPD
• FCRX Inc

  • Pharmacy
  • Charlotte, NC
  • NPI 1366802407
  NPD (past)
• MC Family Medical, PLLC

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1780825539
  NPD (past)

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

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1962123265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 WEDGEDALE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282104544",
            "telephone_number": "703-400-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 HIGHWAY 160 W",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088025",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19305 Ruby Dr",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "VA",
            "postal_code": "201766508",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2340 Spring Forest Rd",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276157528",
            "country_code": "US",
            "telephone_number": "877-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYDELL",
        "first_name": "KELLY",
        "middle_name": "WILLIAMS",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-06",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5016854",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "27403",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024191517",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021706",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "WILLIAMS",
            "middle_name": "LIANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carlton D Rucker, DDS
• Mary Runyon, ATC
• Rudiko Rusia, MD
• Hannah L Russell, PHARMD
• Brandi Bence Ruth, BCBA
• Bailey Sage, RBT
• Jared A Sams, DC
• Jamille Segarra Sanchez, OTR/L
• Julia Sander, LMSW
• Carmen Sanders, RBT

• Family Nurse Practitioner in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.