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KELLY TALLY DPM
NPI 1932673902
Podiatrist - Foot & Ankle Surgery in Suwanee, GA

Active since January 14, 2019PECOS Enrolled
1300 PEACHTREE INDUSTRIAL BLVD STE 4105, SUWANEE, GA 30024(470) 589-1204(470) 589-1465 Get Directions Write a Review

NPPES record last updated: March 5, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 5, 2023, Jul 16, 2021, Jan 14, 2019 (3 updates tracked since 2019).

About Kelly Tally Dpm NPPES

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

KELLY TALLY DPM (NPI 1932673902) is an individual foot & ankle surgery provider in Suwanee, Georgia, licensed in Georgia (POD001396) and active in the NPI registry since January 2019. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1932673902
Entity TypeIndividualFemale
Primary Taxonomy213ES0103X
Provider Legal NameKELLY TALLYCredential: DPM
Location Address1300 PEACHTREE INDUSTRIAL BLVD STE 4105Suwanee, GA 30024-4541
Mailing Address1300 Peachtree Industrial Blvd Ste 4105Suwanee, GA 30024-4541 · (470) 589-1204 · Fax (470) 589-1465
Phone(470) 589-1204
Fax(470) 589-1465
Sole ProprietorNo
Enumeration DateJanuary 14, 2019
Last NPPES UpdateMarch 5, 20233 updates tracked since enumeration
NPPES CertifiedMarch 5, 2023
✔ NPI 1932673902 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
License✔ Licensed in GA · POD001396
1300 PEACHTREE INDUSTRIAL BLVD STE 4105, Suwanee, GA 30024
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1590 S Enota Dr NE Ste 1Gainesville, GA 30501-2433 · Phone (470) 252-5756 · Fax (470) 252-5829
Location 22701 N Decatur RdDecatur, GA 30033-5918 · Phone (404) 501-7188

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Tally Dpm 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.

Medicare Billing Reassignment

Medicare enrollment records show Kelly Tally reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Suwanee Foot And Ankle Specialists LLC
Same address
Foot & Ankle Surgery
1300 PEACHTREE INDUSTRIAL BLVD STE 4105
Suwanee, GA 30024
  • Reassigned Medicare billing, Georgia enrollment
  • 2 clinicians in this Medicare group
NPI 1184292138 (470) 589-1204

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 2

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

SUWANEE FOOT AND ANKLE SPECIALISTS LLC
Podiatrist (Foot & Ankle Surgery)
1300 PEACHTREE INDUSTRIAL BLVD STE 4105
SUWANEE, GA 30024
Gwinnett County (470) 589-1204
DR. TOMMY LEE TALLY D.P.M.
Podiatrist (Foot & Ankle Surgery)
1300 PEACHTREE INDUSTRIAL BLVD STE 4105
SUWANEE, GA 30024
Gwinnett County (470) 589-1204

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 Tally's NPI number?

The NPI number for Kelly Tally is 1932673902. It was assigned to this individual provider in the NPPES registry on January 14, 2019.

Where is Kelly Tally located?

Kelly Tally practices at 1300 Peachtree Industrial Blvd Ste 4105, Suwanee, GA 30024. The listed phone number is (470) 589-1204.

What is Kelly Tally's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Is Kelly Tally enrolled in Medicare?

Yes. Kelly Tally is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kelly Tally's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Tally reassigns Medicare benefits to Suwanee Foot And Ankle Specialists LLC (Suwanee, GA). The 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 Kelly Tally's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelly Tally accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Kelly Tally as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelly Tally was last updated on March 5, 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.