KELLY BOYETTE (FNP) – Family Nurse Practitioner, NPI 1053771923
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,652 NURSE PRACTITIONER in GA
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Provider Addresses for KELLY BOYETTE (FNP)
290 WHITE OAK DRIVE NE
LUDOWICI, GA 31316
Phone: (912) 294-4479
Type: Mailing
124, Memorial Drive, Jesup, Wayne County, Georgia, 31545, United States
JESUP, GA 315450101
Phone: (912) 427-4413
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $288.
Total Amount is formed as General ($288) + Research ($0) + Ownership ($0) = $288.
Last reported payment date: 2024-07-25 • Largest payer in this snapshot: Medtronic, Inc. ($140).
Total Amount
$288
General + Research + Ownership
Payments
4
Total payment records
General Amount
$288
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-25
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2016-05-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20160509002094 | I | Nurse Practitioner | GA | 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 31316)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | NC | |
| - | NC | |
| - | SC | |
| - | GA | |
| - | GA | |
| Emergency Medicine | SC | |
| Emergency Medicine | GA | |
| Emergency Medicine | VA | |
| Emergency Medicine | OH | |
| - | SC |
Reviews
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