Individual provider Active NPI

Kelly Michelle Collins, NP

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1962296483
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
30221 Issued in SC
Practice address
136 Stonemark LN Ste 100C
Columbia, SC 29210-3881
Phone
(888) 704-4661
Fax
(888) 239-2595
NPI assigned
Apr 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 30221 SC Primary

Addresses

Primary practice location

136 Stonemark LN Ste 100C
Columbia, SC 29210-3881

Mailing address

2050 Sunset Dr
Seneca, SC 29672-7959
Phone (864) 506-3232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20250917001620 SC Practitioner - Nurse Practitioner 9638673213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

136 Stonemark LN
Suite 100C
Columbia, SC 29210-3881
Phone (800) 932-2738

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospice Care of South Carolina, LLC CurrentSince Aug 12, 2025 Accepting new patients

Locations

136 Stonemark Ln
Ste 100C
Columbia, SC 29210
Phone (888) 701-4661

187 N Church St
Ste 201
Spartanburg, SC 29306
Phone (864) 630-8469

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1744070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1962296483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 SUNSET DR",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296727959",
            "telephone_number": "864-506-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 STONEMARK LN STE 100C",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292103881",
            "telephone_number": "888-704-4661",
            "fax_number": "888-239-2595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "KELLY",
        "middle_name": "MICHELLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "30221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.