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DR. TYLER KELLY MD
NPI 1114855053
Student in an Organized Health Care Education/Training Program in Greenville, NC

Active since May 11, 2026PECOS Enrolled
2100 STANTONSBURG RD, GREENVILLE, NC 27834(252) 744-4611(252) 744-0060 Get Directions Write a Review

NPPES record last updated: May 11, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Tyler Kelly Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TYLER KELLY MD (NPI 1114855053) is an individual student in an organized health care education/training program in Greenville, North Carolina and active in the NPI registry since May 2026. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114855053
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDR. TYLER KELLYCredential: MD
Location Address2100 STANTONSBURG RDGreenville, NC 27834-2818
Mailing Address2100 Stantonsburg RdGreenville, NC 27834-2818 · (252) 744-4611 · Fax (252) 744-0060
Phone(252) 744-4611
Fax(252) 744-0060
Sole ProprietorNo
Enumeration DateMay 11, 2026
NPPES CertifiedMay 11, 2026
✔ NPI 1114855053 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2100 STANTONSBURG RD, Greenville, NC 27834
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Tyler Kelly Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHRYN M DONATO CRNA
Nurse Anesthetist, Certified Registered
2100 STANTONSBURG RD
GREENVILLE, NC 27834
Pitt County (252) 847-4100
DR. STEPHEN ERIC GREGG M.D.
Student in an Organized Health Care Education/Training Program
2100 STANTONSBURG RD
GREENVILLE, NC 27834
Pitt County (252) 744-5262
DR. TYLER RICHARD FLEMING MD
Student in an Organized Health Care Education/Training Program
2100 STANTONSBURG RD
GREENVILLE, NC 27834
Pitt County (252) 847-4100
MARY CLAIRE CRON PA-C
Physician Assistant
2100 STANTONSBURG RD
GREENVILLE, NC 27834
Pitt County (252) 816-2273
DR. SETH TYLER SCHIPINSKI DO
Student in an Organized Health Care Education/Training Program
2100 STANTONSBURG RD
GREENVILLE, NC 27834
Pitt County (252) 744-4611
BRIANNAE THEODORE
Student in an Organized Health Care Education/Training Program
2100 STANTONSBURG RD
GREENVILLE, NC 27834
Pitt County (252) 744-3229
SHELLEY ELIZABETH MATTHEWS
Student in an Organized Health Care Education/Training Program
2100 STANTONSBURG RD
GREENVILLE, NC 27834
Pitt County (910) 298-3125
LEONARDO JOSE DIAZ GANDICA MD
Student in an Organized Health Care Education/Training Program
2100 STANTONSBURG RD
GREENVILLE, NC 27834
Pitt County (252) 744-5291

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tyler Kelly's NPI number?

The NPI number for Tyler Kelly is 1114855053. It was assigned to this individual provider in the NPPES registry on May 11, 2026.

Where is Tyler Kelly located?

Tyler Kelly practices at 2100 Stantonsburg Rd, Greenville, NC 27834. The listed phone number is (252) 744-4611.

What is Tyler Kelly's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Tyler Kelly enrolled in Medicare?

Yes. Tyler Kelly is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tyler Kelly was last updated on May 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.