CARON BOWEN KELLY NP
NPI 1578073912
Nurse Practitioner - Family in Dacula, GA

Q: What is Caron Kelly's NPI number?

The NPI number for Caron Kelly is 1578073912. It was assigned to this individual provider in the NPPES registry on October 11, 2017.

Q: What is Caron Kelly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Caron Kelly was last updated on July 21, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 11, 2017PECOS Enrolled

3027 JIM MOORE RD, DACULA, GA 30019(770) 339-0129 Get Directions Write a Review

NPPES record last updated: July 21, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 21, 2021, Oct 31, 2017, Oct 11, 2017 (3 updates tracked since 2017).

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About Caron Bowen Kelly Np NPPES

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

CARON BOWEN KELLY NP (NPI 1578073912) is an individual family provider in Dacula, Georgia, licensed in Georgia (RN218152) and active in the NPI registry since October 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1578073912

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameCARON BOWEN KELLYCredential: NP

Location Address3027 JIM MOORE RDDacula, GA 30019-1144

Mailing Address3027 Jim Moore RdDacula, GA 30019-1144 · (770) 339-0129

Phone(770) 339-0129

Sole ProprietorNo

Enumeration DateOctober 11, 2017

Last NPPES UpdateJuly 21, 20213 updates tracked since enumeration

NPPES CertifiedJuly 2, 2021

✔ NPI 1578073912 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in GA · RN218152

3027 JIM MOORE RD, Dacula, GA 30019

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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)

Caron Bowen Kelly Np 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30019 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

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

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.