MILLIE KELLEY (M.A., CCC-A) – Audiologist, NPI 1568636363

MILLIE KELLEY (M.A., CCC-A) is a healthcare provider. based in Snellville, Georgia. specializing in QUALIFIED AUDIOLOGIST. They hold the professional credentials M.A., CCC-A. They hold a License No. AUD003616 (GA). The NPI Number for MILLIE KELLEY (M.A., CCC-A) is 1568636363

Main info

Female
27 Years Of Experience
Accepts Medicare Assignment
Name
MILLIE KELLEY (M.A., CCC-A)
NPI
1568636363
Phone
(770) 985-6233
Address
1700 TREE LANE RD
Enumeration Date
14 April 2008
Last Update Date
14 April 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7705381818
Graduation Year
1999 (27 years ago)
PAC ID
5597835454
Group Practice PAC ID
3375774011
Professional Enrollment ID
I20080604000053
Address ID
GA300241951SU4320XRDXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

263 QUALIFIED AUDIOLOGIST in GA

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Provider Addresses for MILLIE KELLEY (M.A., CCC-A)

  • 1700, Tree Lane, Snellville, Gwinnett County, Georgia, 30078, United States

    SUITE 320

    SNELLVILLE, GA 300786782

    Phone: (770) 985-6233

    Fax: (770) 985-6864

    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)

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: 2008-06-04

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
I20080604000053IQualified AudiologistGATBD

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 30078)

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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: 3375774011View full group profile

Reviews

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Frequently asked questions

What federal number belongs to MILLIE KELLEY (M.A., CCC-A)?
The federal identifier for MILLIE KELLEY (M.A., CCC-A) is NPI 1568636363.
Does this profile mean MILLIE KELLEY (M.A., CCC-A) is currently active?
Yes — MILLIE KELLEY (M.A., CCC-A) appears active in the national provider directory.
Can you summarize MILLIE KELLEY (M.A., CCC-A)'s specialty in plain language?
Clinically, the directory lists MILLIE KELLEY (M.A., CCC-A) with Audiologist. Clinical services aligned with this taxonomy classification.
What location metadata exists for MILLIE KELLEY (M.A., CCC-A)?
The page summarizes Snellville, Georgia for MILLIE KELLEY (M.A., CCC-A); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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