KELLY SOUTH – Nurse Practitioner, NPI 1205203270
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
14,984 NURSE PRACTITIONER in OH
Provider Addresses for KELLY SOUTH
1141 N Monroe Dr
Xenia, OH 453851619
Phone: (937) 352-2500
Type: Location
8701 Old Troy Pike
Huber Heights, OH 454241066
Phone: (937) 558-3338
Type: Location
4000 Miamisburg Centerville Rd
Miamisburg, OH 453427615
Phone: (937) 384-8791
Type: Location
3535 Pentagon Blvd
Beavercreek, OH 454311705
Phone: (937) 702-4500
Type: Location
3131 NEWMARK DR STE 220
MIAMISBURG, OH 453425400
Phone: (937) 436-4658
Fax: (937) 436-4984
Type: Mailing
3535 SOUTHERN BLVD
KETTERING, OH 454291221
Phone: (937) 395-8166
Fax: (937) 395-8347
Type: Location
100 Kettering Way
Franklin, OH 450051155
Phone: (937) 458-4700
Type: Location
600 W Main St
Troy, OH 453732928
Phone: (937) 980-7010
Fax: (937) 980-7019
Type: Location
6147 State Route 122
Middletown, OH 450055201
Phone: (513) 261-3410
Fax: (513) 261-3419
Type: Location
450 Washington Jackson Rd Ste F
Eaton, OH 453208699
Phone: (937) 456-8376
Fax: (937) 456-8377
Type: Location
1997 Miamisburg Centerville Rd
Centerville, OH 454593811
Phone: (937) 401-6228
Fax: (937) 401-6447
Type: Location
405 W Grand Ave
Dayton, OH 454057538
Phone: (937) 723-3211
Fax: (937) 723-4609
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $38.
Total Amount is formed as General ($38) + Research ($0) + Ownership ($0) = $38.
Last reported payment date: 2024-10-07 • Largest payer in this snapshot: ABIOMED ($38).
Total Amount
$38
General + Research + Ownership
Payments
2
Total payment records
General Amount
$38
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABIOMED | $38 |
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: 2015-11-06
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 |
|---|---|---|---|---|
| I20151106000347 | I | Nurse Practitioner | OH | 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 |
|---|---|---|---|---|
| 99284 | Emergency department visit with moderate level of medical decision making | 39 | 39 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 19 | 19 | $0 |
Insurance plans in this area (ZIP 45385)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | OH | |
| Emergency Medicine | OH | |
| Emergency Medicine | OH | |
| Emergency Medicine | OH | |
| Emergency Medicine | OH | |
| Emergency Medicine | OH | |
| Emergency Medicine | OH | |
| - | OH | |
| - | OH | |
| Emergency Medicine | OH |
Reviews
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