KELLY HEALTH & WELLNESS CLINIC LLC
NPI 1982593935
Nurse Practitioner - Family in Greenwood, MS
About Kelly Health & Wellness Clinic Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY HEALTH & WELLNESS CLINIC LLC (NPI 1982593935) is a healthcare organization registered as a family in Greenwood, Mississippi and active in the NPI registry since July 2025. The organization holds a CLIA Waiver certificate valid through July 16, 2027 and lists Joby G Kelly, Owner/provider, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kelly Health & Wellness Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Kelly Health & Wellness Clinic LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 25D2327158
Kelly Health & Wellness Clinic · Greenwood, MSFrequently 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 Health & Wellness Clinic LLC's NPI number?
The NPI number for Kelly Health & Wellness Clinic LLC is 1982593935. It was assigned to this organization in the NPPES registry on July 2, 2025.
Where is Kelly Health & Wellness Clinic LLC located?
Kelly Health & Wellness Clinic LLC is located at 102 E Claiborne Ave Ste D, Greenwood, MS 38930. The listed phone number is (662) 219-3513.
What is Kelly Health & Wellness Clinic LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kelly Health & Wellness Clinic LLC enrolled in Medicare?
Yes. Kelly Health & Wellness Clinic LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Kelly Health & Wellness Clinic LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Kelly Health & Wellness Clinic LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Kelly Health & Wellness Clinic LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 25D2327158) is associated with this NPI, valid through July 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Kelly Health & Wellness Clinic LLC accept?
Health plans from Molina Healthcare list Kelly Health & Wellness Clinic LLC 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 Health & Wellness Clinic LLC was last updated on July 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.
# Kelly Health & Wellness Clinic Llc · NPI 1982593935
Family organization in Greenwood, Mississippi. Organization record, active in the CMS NPPES registry since July 2, 2025.
## Identity
- **NPI:** 1982593935 (Entity type: Organization)
- **Enumerated:** July 2, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Joby Kelly, OWNER/PROVIDER
## Practice location
- **Address:** 102 E CLAIBORNE AVE STE D, Greenwood, MS 38930-3518
- **Phone:** (662) 219-3513 · **Fax:** (662) 219-3514
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 22, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1982593935) · Data from the CMS NPPES public registry.