KELLY RENAE GRUMMER-SMITH NP-C
NPI 1619310802
Nurse Practitioner - Pediatrics in Tifton, GA

Q: What is Kelly Grummer-smith's NPI number?

The NPI number for Kelly Grummer-smith is 1619310802. It was assigned to this individual provider in the NPPES registry on April 8, 2013.

Q: What is Kelly Grummer-smith's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Active since April 08, 2013PECOS Enrolled

39 KENT RD STE 5, TIFTON, GA 31794(229) 353-7337 Get Directions Write a Review

NPPES record last updated: October 10, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 10, 2025, Mar 24, 2021 (2 updates tracked since 2021).

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About Kelly Renae Grummer-smith Np-c NPPES

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

KELLY RENAE GRUMMER-SMITH NP-C (NPI 1619310802) is an individual pediatrics provider in Tifton, Georgia, licensed in Georgia (NP180155) and active in the NPI registry since April 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619310802

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameKELLY RENAE GRUMMER-SMITHCredential: NP-C

Location Address39 KENT RD STE 5Tifton, GA 31794-1697

Mailing Address907 18th St E Ste 400Tifton, GA 31794-3684 · (229) 353-3422 · Fax (229) 353-6060

Phone(229) 353-7337

Sole ProprietorNo

Enumeration DateApril 8, 2013

Last NPPES UpdateOctober 10, 20252 updates tracked since enumeration

NPPES CertifiedOctober 10, 2025

✔ NPI 1619310802 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

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

Taxonomy Code363LP0200X

License✔ Licensed in GA · NP180155

Also ListedRegistered Nurse · Lactation ConsultantTaxonomy 163WL0100X · License RN180155 (GA), 545382 (CA)

39 KENT RD STE 5, Tifton, GA 31794

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health 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 (PECOS)

Kelly Renae Grummer-smith Np-c 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 31794 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

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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 9

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

REBECCA CONDON STAUB MD

Pediatrics