KIMBERLY KELLEY NP
NPI 1750032645
Nurse Practitioner - Psychiatric/Mental Health in Jackson, MS

Q: What is Kimberly Kelley's NPI number?

The NPI number for Kimberly Kelley is 1750032645. It was assigned to this individual provider in the NPPES registry on January 12, 2022.

Q: What is Kimberly Kelley's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Kimberly Kelley was last updated on January 12, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since January 12, 2022PECOS EnrolledAccepts Medicare Assignment

3450 HIGHWAY 80 W, JACKSON, MS 39209(601) 321-2400 Get Directions Write a Review

NPPES record last updated: January 12, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

On this page

About Kimberly Kelley Np NPPES

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

KIMBERLY KELLEY NP (NPI 1750032645) is an individual psychiatric/mental health provider in Jackson, Mississippi, licensed in Mississippi (903622) and active in the NPI registry since January 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1750032645

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameKIMBERLY KELLEYCredential: NP

Location Address3450 HIGHWAY 80 WJackson, MS 39209-7201

Mailing Address139 Brierfield DrMadison, MS 39110-7767 · (601) 720-7957

Phone(601) 321-2400

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateJanuary 12, 2022

NPPES CertifiedJanuary 12, 2022

✔ NPI 1750032645 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in MS · 903622

3450 HIGHWAY 80 W, Jackson, MS 39209

Open in Google Maps ↗

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

Kimberly Kelley Np 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 ID8426438086

PECOS Enrollment IDI20220629002453

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

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 low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

218 services56 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39209 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.

Leave this field empty

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.

ELLEEANNA LAWSON CAT,LMSW

Counselor (Addiction (Substance Use Disorder))