KELLEE MATLOCK (CRNA) – Certified Registered Nurse Anesthetist, NPI 1174570238

KELLEE MATLOCK (CRNA) is a healthcare provider. based in Little rock, Arkansas. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. C01294 (AR). The NPI Number for KELLEE MATLOCK (CRNA) is 1174570238

Main info

Female
26 Years Of Experience
Accepts Medicare Assignment
Name
KELLEE MATLOCK (CRNA)
NPI
1174570238
Phone
(501) 227-7797
Address
1415 BRECKENRIDGE DR
Enumeration Date
27 May 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2143850865
Graduation Year
2000 (26 years ago)
PAC ID
4789661851
Group Practice PAC ID
5193228880
Professional Enrollment ID
I20170809003039
Address ID
TX760343548CO4905XCTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

716 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in AR

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Provider Addresses for KELLEE MATLOCK (CRNA)

  • 1415, Breckenridge Drive, Little Rock, Pulaski County, Arkansas, 72227, United States

    STE E

    LITTLE ROCK, AR 722274819

    Phone: (501) 227-7797

    Fax: (501) 227-7753

    Type: Mailing

  • 10301, Kanis Road, Little Rock, Pulaski County, Arkansas, 72205, United States

    LITTLE ROCK, AR 722056205

    Phone: (501) 227-7797

    Fax: (501) 227-7753

    Type: Location

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: 2017-08-09

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
I20170809003039ICertified Registered Nurse Anesthetist (Crna)TXTBD

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
00142Anesthesia for lens surgery1211$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1212$0
01940Anesthesia for nerve destruction procedures on spine or spinal cord of lower back accessed through skin using imaging guidance1212$0
View full utilization report →

Insurance plans in this area (ZIP 72227)

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Provider's Procedures

KELLEE MATLOCK (CRNA) performs procedures in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CERTIFIED REGISTERED NURSE ANESTHETAR01402Anesthesia for open or endoscopic total knee joint replacement4747

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: 5193228880View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)TX
A N E S T H E S I O L O G YTX
A N E S T H E S I O L O G YTX
A N E S T H E S I O L O G YTX
Certified Registered Nurse Anesthetist (Crna)TX
Anesthesiology, Pain ManagementTX
Certified Registered Nurse Anesthetist (Crna)TX
A N E S T H E S I O L O G YTX
Certified Registered Nurse Anesthetist (Crna)MS
Certified Registered Nurse Anesthetist (Crna)TX

Reviews

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Frequently asked questions

What identifier follows KELLEE MATLOCK (CRNA) across health systems?
The NPI 1174570238 uniquely identifies KELLEE MATLOCK (CRNA) in U.S. healthcare data.
Should I treat KELLEE MATLOCK (CRNA) as an active provider?
Patients and plans typically see KELLEE MATLOCK (CRNA) as active in the national extract.
What does the directory say KELLEE MATLOCK (CRNA) does?
Insurance directories may phrase it differently, but here KELLEE MATLOCK (CRNA) maps to Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to KELLEE MATLOCK (CRNA)?
KELLEE MATLOCK (CRNA) is associated with Little Rock, Arkansas in the same public data insurers reference.
Can I export KELLEE MATLOCK (CRNA)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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