KELLIE WHITENER – Family Nurse Practitioner, NPI 1093301855

KELLIE WHITENER is a healthcare provider. based in Statesboro, Georgia. specializing in NURSE PRACTITIONER. They hold a License No. RN213296 (GA). The NPI Number for KELLIE WHITENER is 1093301855

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
KELLIE WHITENER
NPI
1093301855
Phone
(912) 489-4090
Address
23702 HWY 80 E
Enumeration Date
16 December 2020
Last Update Date
16 December 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9124894090
Graduation Year
2018 (8 years ago)
PAC ID
2567846074
Group Practice PAC ID
4082601299
Professional Enrollment ID
I20220901001933
Address ID
GA304610845ST23702EXXX400

Contacts

Secure Messaging
0509.0001@direct.familyhealthcare.nextgenshare.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness85
Years active:5State licenses:1Other namesUpdated within 12 months

9,652 NURSE PRACTITIONER in GA

Provider Addresses for KELLIE WHITENER

  • 23702 HWY 80 E

    STATESBORO, GA 304610845

    Phone: (912) 489-4090

    Fax: (912) 764-8378

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 129 Open Payments records for all available years, with a total value of $2,475.

Total Amount is formed as General ($2,475) + Research ($0) + Ownership ($0) = $2,475.

Last reported payment date: 2024-11-22 • Largest payer in this snapshot: ABBVIE INC. ($483).

Total Amount

$2,475

General + Research + Ownership

Payments

129

Total payment records

General Amount

$2,475

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-22

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2022-09-01

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220901001933INurse PractitionerGATBD

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.

Verify on CMS Revalidation Lookup Tool

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 30461)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082601299View full group profile
NameSpecialtyState
Family PracticeGA
-GA
-GA
Nurse PractitionerGA
Family PracticeGA

Reviews

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Frequently asked questions

Does KELLIE WHITENER have a public NPI I can cite?
Public records show KELLIE WHITENER under NPI 1093301855.
Quick check: is KELLIE WHITENER active?
Public NPPES data shows KELLIE WHITENER with an active NPI status right now.
What type of care does KELLIE WHITENER provide?
KELLIE WHITENER's profile centers on Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What geographic area is tied to KELLIE WHITENER?
KELLIE WHITENER is associated with Statesboro, Georgia in the same public data insurers reference.
Who maintains KELLIE WHITENER's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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