KELLY COSTELLO BLACKMON (APRN) – Nurse Practitioner, NPI 1992110688
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,658 NURSE PRACTITIONER in GA
Provider Addresses for KELLY COSTELLO BLACKMON (APRN)
1706 ALICE ST
WAYCROSS, GA 315015216
Phone: (912) 285-1140
Fax: (912) 285-1125
Type: Location
PO BOX 0070
VALDOSTA, GA 316030070
Phone: (229) 259-4369
Fax: (229) 433-6513
Type: Mailing
2409 N. PATTERSON STREET
SUITE 230
VALDOSTA, GA 316022512
Phone: (229) 259-4369
Fax: (229) 433-6513
Type: Location
2409 N. Patterson Street
Suite 230
Valdosta, GA 316022512
Phone: (229) 259-4369
Fax: (229) 433-6513
Type: Location
PO BOX 749495
ATLANTA, GA 303749495
Phone: (855) 963-2100
Fax: (239) 236-2775
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 31 Open Payments records for all available years, with a total value of $2,351.
Total Amount is formed as General ($2,351) + Research ($0) + Ownership ($0) = $2,351.
Last reported payment date: 2024-01-31 • Largest payer in this snapshot: Medtronic, Inc. ($1,736).
Total Amount
$2,351
General + Research + Ownership
Payments
31
Total payment records
General Amount
$2,351
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-01-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $1,736 |
| Abbott Laboratories | $274 |
| ATRICURE, INC. | $178 |
| AstraZeneca Pharmaceuticals LP | $48 |
| GENZYME CORPORATION | $24 |
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: 2015-04-01
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20150401001028 | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 24 | 19 | $0 |
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 19 | 15 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 15 | 11 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 14 | 13 | $0 |
Insurance plans in this area (ZIP 31501)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| H E M A T O L O G Y/ O N C O L O G Y | DE | |
| Nurse Practitioner | NC | |
| Nurse Practitioner | FL | |
| P A T H O L O G Y | FL | |
| Hematology/Oncology, Internal Medicine | TX | |
| - | MO | |
| Nurse Practitioner | MD | |
| - | GA | |
| - | FL | |
| Physician Assistant | FL |
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