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KELLY BROOKE ENGELMANN CFNP
NPI 1710096656
Nurse Practitioner - Family in Jackson, MS

Active since August 30, 2006Opted out of Medicare · through Oct 1, 2026
1855 LAKELAND DR, STE. M20, JACKSON, MS 39216(601) 364-1132(601) 364-1134 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Kelly Brooke Engelmann Cfnp NPPES

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

KELLY BROOKE ENGELMANN CFNP (NPI 1710096656) is an individual family provider in Jackson, Mississippi, licensed in Mississippi (R805546) and active in the NPI registry since August 2006. She has opted out of Medicare through October 1, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1710096656
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKELLY BROOKE ENGELMANNCredential: CFNP
Location Address1855 LAKELAND DR, STE. M20Jackson, MS 39216-4913
Mailing Address105 Honeybee CvBrandon, MS 39047-7703 · (601) 862-1404
Phone(601) 364-1132
Fax(601) 364-1134
Sole ProprietorYes
Enumeration DateAugust 30, 2006
Last NPPES UpdateMarch 7, 2023
✔ NPI 1710096656 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 MS · R805546
1855 LAKELAND DR, Jackson, MS 39216
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Kelly Brooke Engelmann Cfnp has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2016 through October 1, 2026.

Opt-Out Effective DateOctober 1, 2016
Opt-Out In Effect ThroughOctober 1, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39216 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
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
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 17

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

MRS. DENEASE INEZ BISHOP LPC, LMFT
Counselor (Professional)
1855 LAKELAND DR, SUITE P101
JACKSON, MS 39216
Hinds County (601) 278-6790
HART KATHERINE WYLIE PMHNP, LPC
Nurse Practitioner (Psychiatric/Mental Health)
1855 LAKELAND DR, SUITE P-121
JACKSON, MS 39216
Hinds County (601) 366-4696
LISA L DALTON NP
Nurse Practitioner (Family)
1855 LAKELAND DR, STE M20
JACKSON, MS 39216
Hinds County (601) 364-1132
EMILY GOEGLEIN
Counselor (Professional)
1855 LAKELAND DR
JACKSON, MS 39216
Hinds County (601) 366-4696
PORTABLE MEDICAL DIAGNOSTICS LLC
Clinic/Center (Radiology, Mobile)
1855 LAKELAND DR, STE G10
JACKSON, MS 39216
Hinds County (601) 987-9729
BYRON GALLOWAY LMFT
Marriage & Family Therapist
1855 LAKELAND DR, SUITE R-204
JACKSON, MS 39216
Hinds County (601) 982-5376
DR. DOUGLAS WILLIAM BYRD M.D.
Psychiatry & Neurology (Psychiatry)
1855 LAKELAND DR, SUITE P-231
JACKSON, MS 39216
Hinds County (601) 366-4696
MRS. ELIZABETH P TAYLOR M.S., LPC
Counselor
1855 LAKELAND DR, SUITE P121
JACKSON, MS 39216
Hinds County (601) 209-4789

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 Kelly Engelmann's NPI number?

The NPI number for Kelly Engelmann is 1710096656. It was assigned to this individual provider in the NPPES registry on August 30, 2006.

Where is Kelly Engelmann located?

Kelly Engelmann practices at 1855 Lakeland Dr Ste. M20, Jackson, MS 39216. The listed phone number is (601) 364-1132.

What is Kelly Engelmann's specialty?

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

Is Kelly Engelmann enrolled in Medicare?

No. Kelly Engelmann has opted out of Medicare through October 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Kelly Engelmann was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.