KELLIE DUVALL SOUTHER
NPI 1558846527
Nurse Practitioner in Mocksville, NC

Q: What is Kellie Souther's NPI number?

The NPI number for Kellie Souther is 1558846527. It was assigned to this individual provider in the NPPES registry on September 26, 2018.

Q: What is Kellie Souther's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Kellie Souther was last updated on December 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.

Active since September 26, 2018PECOS EnrolledAccepts Medicare Assignment

1188 YADKINVILLE RD, MOCKSVILLE, NC 27028(336) 716-7435(336) 702-9277 Get Directions Write a Review

NPPES record last updated: December 5, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 5, 2023, Oct 16, 2023, Jan 10, 2022 and 1 more (4 updates tracked since 2018).

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About Kellie Duvall Souther NPPES

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

KELLIE DUVALL SOUTHER (NPI 1558846527) is an individual nurse practitioner in Mocksville, North Carolina, licensed in North Carolina (5011023) and active in the NPI registry since September 2018. She is enrolled in Medicare PECOS, is affiliated with North Carolina Baptist Hospital, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1558846527

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameKELLIE DUVALL SOUTHER

Location Address1188 YADKINVILLE RDMocksville, NC 27028-2037

Mailing Address100 Kimel Forest DrWinston Salem, NC 27103-6074 · (336) 713-0947

Phone(336) 716-7435

Fax(336) 702-9277

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateSeptember 26, 2018

Last NPPES UpdateDecember 5, 20234 updates tracked since enumeration

NPPES CertifiedDecember 5, 2023

✔ NPI 1558846527 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in NC · 5011023

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 5011023 (NC)

1188 YADKINVILLE RD, Mocksville, NC 27028

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kellie Duvall Souther is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6709121205

PECOS Enrollment IDI20190102000876

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.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

78 services67 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

38 services19 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

22 services17 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

17 services17 patients

Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 87880

A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.

15 services15 patients

Injection, ketorolac tromethamine, per 15 mg J1885

Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.

14 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

North Carolina Baptist Hospital

Acute Care Hospitals · Winston-Salem, NC

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number340047

LocationMedical Center BoulevardWinston-Salem, NC 27157 · Forsyth County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27028 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$95.94 typical visit price

range $17.21 – $134.61

Typical copayment $23.98 (range $4.30 – $33.65)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

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

ALISON L MCNEIL PA

Physician Assistant