JANETTA M KELLY (M.D.) – Pediatrics Physician, NPI 1669666814
Pediatrics Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JANETTA M KELLY (M.D.)
770 VILLAGE SQUARE DR
STONE MOUNTAIN, GA 300833380
Phone: (404) 323-2988
Type: Location
770 Village Square Dr
Stone Mountain, GA 300833380
Phone: (404) 323-2988
Type: Location
710 CENTER ST
COLUMBUS, GA 319011527
Phone: (706) 571-1311
Type: Location
Rice Box, Atlanta BeltLine Eastside Trail, Atlanta, Georgia, 30308, United States
ATLANTA, GA 311191472
Phone: (404) 323-2988
Type: Mailing
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: 2024-03-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
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 |
|---|---|---|---|---|
| I20140109001522 | I | Pediatric Medicine | IN | TBD |
| I20220504002964 | I | Pediatric Medicine | WA | TBD |
| I20230522000273 | I | Pediatric Medicine | NM | TBD |
| I20240321000667 | I | Pediatric Medicine | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30083)
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