MRS. KELLILYN WORLEY (MS, RDN, LD) – Registered Dietitian, NPI 1760703045
Registered Dietitian
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
80 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in AL
Provider Addresses for MRS. KELLILYN WORLEY (MS, RDN, LD)
1803A E Three Notch St
Andalusia, AL 364212403
Phone: (409) 767-8100
Fax: (888) 977-1202
Type: Location
6165 CARNATION DR
BEAUMONT, TX 777065502
Phone: (409) 454-0417
Fax: (409) 861-2021
Type: Mailing
6282 PHELAN BLVD
BEAUMONT, TX 777066120
Phone: (409) 454-0417
Type: Location
30153 SANDY LANDING RD
ANDALUSIA, AL 364219157
Phone: (409) 454-0417
Fax: (888) 977-1202
Type: Mailing
985 INTERSTATE 10 N STE 110F
BEAUMONT, TX 777064815
Phone: (409) 767-8100
Fax: (888) 977-1202
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-11-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20150414001817 | I | Registered Dietitian Or Nutrition Professional | TX | TBD |
| I20221106000054 | I | Registered Dietitian Or Nutrition Professional | AL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 36421)
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