MRS. KELLIE CAIN HENDERSON (NP-C) – Family Nurse Practitioner, NPI 1720459621

MRS. KELLIE CAIN HENDERSON (NP-C) is a healthcare provider. based in Cumming, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials NP-C. They hold a License No. RN200046 (GA). The NPI Number for MRS. KELLIE CAIN HENDERSON (NP-C) is 1720459621

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
MRS. KELLIE CAIN HENDERSON (NP-C)
NPI
1720459621
Phone
(770) 889-9901
Address
1100 NORTHSIDE FORSYTH DR
Enumeration Date
18 October 2015
Last Update Date
18 October 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7708899901
Graduation Year
2015 (11 years ago)
PAC ID
8325324080
Group Practice PAC ID
0941269591
Professional Enrollment ID
I20170411002279
Address ID
GA300416020CU1100XDRXX402
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

9,652 NURSE PRACTITIONER in GA

Provider Addresses for MRS. KELLIE CAIN HENDERSON (NP-C)

  • 1100 NORTHSIDE FORSYTH DR

    SUITE 330

    CUMMING, GA 300416012

    Phone: (770) 889-9901

    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 38 Open Payments records for all available years, with a total value of $890.

Total Amount is formed as General ($890) + Research ($0) + Ownership ($0) = $890.

Last reported payment date: 2024-11-14 • Largest payer in this snapshot: ABBVIE INC. ($198).

Total Amount

$890

General + Research + Ownership

Payments

38

Total payment records

General Amount

$890

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-14

Latest reported date

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: 2017-04-11

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
I20170411002279INurse 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes227182$0
99203New patient office or other outpatient visit, 30-44 minutes121121$0
99204New patient office or other outpatient visit, 45-59 minutes1111$0
View full utilization report →

Insurance plans in this area (ZIP 30041)

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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: 0941269591View full group profile
NameSpecialtyState
G A S T R O E N T E R O L O G YGA

Reviews

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Frequently asked questions

What federal number belongs to MRS. KELLIE CAIN HENDERSON (NP-C)?
The federal identifier for MRS. KELLIE CAIN HENDERSON (NP-C) is NPI 1720459621.
Is MRS. KELLIE CAIN HENDERSON (NP-C)'s NPI currently valid?
The extract we use shows MRS. KELLIE CAIN HENDERSON (NP-C) as active.
Can you summarize MRS. KELLIE CAIN HENDERSON (NP-C)'s specialty in plain language?
Clinically, the directory lists MRS. KELLIE CAIN HENDERSON (NP-C) with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where does public data place MRS. KELLIE CAIN HENDERSON (NP-C)?
The snapshot lists Cumming, Georgia for MRS. KELLIE CAIN HENDERSON (NP-C); download NPPES for the complete set.
What if Cumming, Georgia seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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