Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MRS. KELLY WILLIAMS RYDELL FNP
NPI 1962123265
Nurse Practitioner - Family in Davidson, NC

Active since September 06, 2022PECOS Enrolled
127 S MAIN ST, DAVIDSON, NC 28036(866) 389-2727 Get Directions Write a Review

NPPES record last updated: October 20, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 9, 2025, Jun 5, 2023, Sep 12, 2022 and 1 more (4 updates tracked since 2022).

About Mrs. Kelly Williams Rydell Fnp NPPES

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

MRS. KELLY WILLIAMS RYDELL FNP (NPI 1962123265) is an individual family provider in Davidson, North Carolina, licensed in South Carolina (27403) and active in the NPI registry since September 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1962123265
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. KELLY WILLIAMS RYDELLCredential: FNP
Location Address127 S MAIN STDavidson, NC 28036-8096
Mailing Address16030 Glen Miro DrHuntersville, NC 28078-2258 · (703) 400-2551
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateSeptember 6, 2022
Last NPPES UpdateOctober 20, 20264 updates tracked since enumeration
NPPES CertifiedOctober 20, 2026
✔ NPI 1962123265 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
Licenses✔ Licensed in SC · 27403✔ Licensed in CA · 95021706✔ Licensed in NC · 5016854✔ Licensed in VA · 0024191517
127 S MAIN ST, Davidson, NC 28036

Other Names 1

Former Name (1)Kelly Lianne Williams

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Kelly Williams Rydell Fnp 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 ID8729449616
PECOS Enrollment IDI20230725000959
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 Reassignments

7

Medicare enrollment records show Kelly Rydell reassigns Medicare billing to 7 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Family
698 FAIRVIEW RD
Simpsonville, SC 29680
  • Reassigned Medicare billing, South Carolina enrollment
  • 176 clinicians in this Medicare group
Family
698 FAIRVIEW RD
Simpsonville, SC 29680
  • Reassigned Medicare billing, South Carolina enrollment
  • 112 clinicians in this Medicare group
Family
2340 SPRING FOREST RD
Raleigh, NC 27615
  • Reassigned Medicare billing, North Carolina enrollment
  • 290 clinicians in this Medicare group
Family
2340 SPRING FOREST RD
Raleigh, NC 27615
  • Reassigned Medicare billing, North Carolina enrollment
  • 168 clinicians in this Medicare group
Family
19305 RUBY DR
Leesburg, VA 20176
  • Reassigned Medicare billing, District of Columbia and Virginia enrollments
  • 266 clinicians in this Medicare group
Family
19305 RUBY DR
Leesburg, VA 20176
  • Reassigned Medicare billing, District of Columbia and Virginia enrollments
  • 114 clinicians in this Medicare group
Family
1 CVS DR
Woonsocket, RI 02895
  • Reassigned Medicare billing, South Carolina enrollment
  • 114 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.

Areas of Expertise CMS Part B claims 2

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.
25 services25 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
16 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28036 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
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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 13

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

Nurse Practitioner (Family)
127 S MAIN ST
DAVIDSON, NC 28036
Pharmacist
127 S MAIN ST
DAVIDSON, NC 28036
Pharmacist
127 S MAIN ST
DAVIDSON, NC 28036
Nurse Practitioner (Family)
127 S MAIN ST
DAVIDSON, NC 28036
Nurse Practitioner (Family)
127 S MAIN ST
DAVIDSON, NC 28036
Pharmacist
127 S MAIN ST
DAVIDSON, NC 28036
Pharmacist
127 S MAIN ST
DAVIDSON, NC 28036
Pharmacy
127 S MAIN ST, BOX 279
DAVIDSON, NC 28036

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 Rydell's NPI number?

The NPI number for Kelly Rydell is 1962123265. It was assigned to this individual provider in the NPPES registry on September 6, 2022. The provider is also known as Kelly Lianne Williams.

Where is Kelly Rydell located?

Kelly Rydell practices at 127 S Main St, Davidson, NC 28036. The listed phone number is (866) 389-2727.

What is Kelly Rydell's specialty?

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

Is Kelly Rydell enrolled in Medicare?

Yes. Kelly Rydell is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kelly Rydell's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Rydell reassigns Medicare benefits to 7 organizations: Minuteclinic Diagnostic South Carolina LLC (Simpsonville, SC), Minuteclinic Primary Care South Carolina LLC (Simpsonville, SC), Minuteclinic Diagnostic Of North Carolina PC (Raleigh, NC), Minuteclinic Primary Care North Carolina PLLC (Raleigh, NC), Minuteclinic Diagnostic Of Virginia LLC (Leesburg, VA) and 2 more organizations, listed in the Medicare section above. 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 Kelly Rydell's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelly Rydell accept?

Health plans from CareSource, CareSource (Common Ground Healthcare) and Oscar Health list Kelly Rydell 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 Rydell was last updated on October 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 days 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.