KELLI WASHINGTON FISHBURNE FNP
NPI 1205679917
Nurse Practitioner - Family in Walterboro, SC
About Kelli Washington Fishburne Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLI WASHINGTON FISHBURNE FNP (NPI 1205679917) is an individual family provider in Walterboro, South Carolina, licensed in South Carolina (F06240189) and active in the NPI registry since June 2024. She is enrolled in Medicare PECOS, is affiliated with Colleton Medical Center, and maintains a secondary practice location in Summerville.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kelli Washington Fishburne Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kelli Fishburne reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Walterboro, SC 29488
- Reassigned Medicare billing, South Carolina enrollment
- 290 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Colleton Medical Center
Acute Care Hospitals · Walterboro, SCPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 29488 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
WALTERBORO, SC 29488
WALTERBORO, SC 29488
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 Kelli Fishburne's NPI number?
The NPI number for Kelli Fishburne is 1205679917. It was assigned to this individual provider in the NPPES registry on June 18, 2024.
Where is Kelli Fishburne located?
Kelli Fishburne practices at 447 Spruce St, Walterboro, SC 29488. The listed phone number is (843) 549-6331.
What is Kelli Fishburne's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kelli Fishburne enrolled in Medicare?
Yes. Kelli Fishburne is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kelli Fishburne's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelli Fishburne reassigns Medicare benefits to Palmetto Primary Care Physicians, LLC (Walterboro, SC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelli Fishburne's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelli Fishburne accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, BlueCross BlueShield of South Carolina and Molina Healthcare list Kelli Fishburne as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Kelli Fishburne affiliated with any hospitals?
According to CMS data, Kelli Fishburne is affiliated with Colleton Medical Center.
When was this NPI record last updated?
The NPPES record for Kelli Fishburne was last updated on August 14, 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.
# Kelli Washington Fishburne, FNP · NPI 1205679917
Family physician in Walterboro, South Carolina. Individual provider, active in the CMS NPPES registry since June 18, 2024.
## Identity
- **NPI:** 1205679917 (Entity type: Individual)
- **Enumerated:** June 18, 2024
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** F06240189 (South Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 447 SPRUCE ST, Walterboro, SC 29488-2766
- **Phone:** (843) 549-6331
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Palmetto Primary Care Physicians, LLC (NPI 1962725176, Walterboro, SC), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** August 14, 2026
- **Other identifiers:** Medicaid NN1868 (SC)
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Source: [NPI Profile](https://npiprofile.com/npi/1205679917) · Data from the CMS NPPES public registry.