MR. JAMES PATRICK KELLY III FNP-BC
NPI 1679062418
Nurse Practitioner - Family in Cookeville, TN
About Mr. James Patrick Kelly Iii Fnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. JAMES PATRICK KELLY III FNP-BC (NPI 1679062418) is an individual family provider in Cookeville, Tennessee, licensed in Tennessee (28550) and active in the NPI registry since May 2018. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. James Patrick Kelly Iii Fnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show James Kelly reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Cookeville, TN 38501
- Reassigned Medicare billing, Tennessee enrollment
- 78 clinicians in this Medicare group
Maryville, TN 37804
- Reassigned Medicare billing, Tennessee enrollment
- 390 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 38501 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
COOKEVILLE, TN 38501
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 James Kelly's NPI number?
The NPI number for James Kelly is 1679062418. It was assigned to this individual provider in the NPPES registry on May 8, 2018.
Where is James Kelly located?
James Kelly practices at 1 Medical Center Blvd, Cookeville, TN 38501. The listed phone number is (931) 528-2541.
What is James Kelly's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is James Kelly enrolled in Medicare?
Yes. James Kelly is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for James Kelly's services?
According to the CMS Revalidation Reassignment List (October 2026 release), James Kelly reassigns Medicare benefits to 2 organizations: Putnam Emergency Physicians, PLLC (Cookeville, TN) and App Of Tennessee Ed, PLLC (Maryville, TN). Each 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 James Kelly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for James Kelly was last updated on August 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Mr. James Patrick Kelly III, FNP-BC · NPI 1679062418
Family physician in Cookeville, Tennessee. Individual provider, active in the CMS NPPES registry since May 8, 2018.
## Identity
- **NPI:** 1679062418 (Entity type: Individual)
- **Enumerated:** May 8, 2018
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 28550 (Tennessee)
- **Sole proprietor:** No
## Practice location
- **Address:** 1 MEDICAL CENTER BLVD, Cookeville, TN 38501-4294
- **Phone:** (931) 528-2541
## 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:** 2 organizations under Medicare reassignment (form CMS-855R): Putnam Emergency Physicians, PLLC (NPI 1891475752, Cookeville, TN); App Of Tennessee Ed, PLLC (NPI 1003230236, Maryville, TN) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 24, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1679062418) · Data from the CMS NPPES public registry.