KADETTE KELLY (CRNA) – Certified Registered Nurse Anesthetist, NPI 1003931502

KADETTE KELLY (CRNA) is a healthcare provider. based in Fontana, California. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. NA3464 (CA). The NPI Number for KADETTE KELLY (CRNA) is 1003931502

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
KADETTE KELLY (CRNA)
NPI
1003931502
Phone
(909) 427-3910
Address
9961 SIERRA AVE
Enumeration Date
21 March 2007
Last Update Date
3 December 2021

Doctor Profile

Medical School Name
COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS
Secondary Phone
9094275000
Graduation Year
2006 (20 years ago)
PAC ID
3274612874
Group Practice PAC ID
6002729175
Professional Enrollment ID
I20080507000683
Address ID
CA923356720FO9961XAVEX300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

2,470 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in CA

Provider Addresses for KADETTE KELLY (CRNA)

  • 9961 SIERRA AVE

    FONTANA, CA 923356720

    Phone: (909) 427-3910

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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: 2008-05-07

PECOS data refreshed: 2026-06-15

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
I20080507000683ICertified Registered Nurse Anesthetist (Crna)CATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92335)

Loading plans...

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: 6002729175View full group profile
NameSpecialtyState
U R O L O G YOH
Nurse PractitionerCA
Internal MedicineCA
Internal MedicineCA
Physician AssistantCA
N E U R O L O G YCA
Internal MedicineCA
O B S T E T R I C S/ G Y N E C O L O G YCA
Family Practice, Sports MedicineCA
Internal MedicineNY

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Can I use this page to confirm KADETTE KELLY (CRNA)'s NPI?
Yes. KADETTE KELLY (CRNA) is listed with NPI 1003931502 in the public NPI dataset.
Does the file indicate KADETTE KELLY (CRNA) is practicing under active NPI?
Directory data currently reports KADETTE KELLY (CRNA) as active.
What is KADETTE KELLY (CRNA)'s primary classification?
Certified Registered Nurse Anesthetist is the headline specialty for KADETTE KELLY (CRNA) here. Clinical services aligned with this taxonomy classification.
Where should I expect KADETTE KELLY (CRNA) on a map?
Expect Fontana, California as a primary anchor for KADETTE KELLY (CRNA) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

Similar Providers

LORETTA MINER GIBSON (CRNA)

Certified Registered Nurse Anesthetist
14145, Southwood Drive, Southridge Village, Fontana, San Bernardino County, California, 92337, United States
NPI: 1629053525

ELLEN MARIE ROTH (C.R.N.A.)

Certified Registered Nurse Anesthetist
Kaiser Permanente Fontana Medical Center, 9961, Sierra Avenue, Fontana, San Bernardino County, California, 92335, United States
NPI: 1093885253

WENDY FLORES (CRNA)

Certified Registered Nurse Anesthetist
Kaiser Permanente Fontana Medical Center, 9961, Sierra Avenue, Fontana, San Bernardino County, California, 92335, United States
NPI: 1982771721

GARY B GLENN (CRNA)

Certified Registered Nurse Anesthetist
9961 Sierra Ave
NPI: 1962579797

DAVID R HAGA (CRNA)

Certified Registered Nurse Anesthetist
Kaiser Permanente Fontana Medical Center, 9961, Sierra Avenue, Fontana, San Bernardino County, California, 92335, United States
NPI: 1235206079

WILLIAM J SCHORK (CRNA)

Certified Registered Nurse Anesthetist
Kaiser Permanente Fontana Medical Center, 9961, Sierra Avenue, Fontana, San Bernardino County, California, 92335, United States
NPI: 1255408019

JEFFREY D CAGLE (CRNA)

Certified Registered Nurse Anesthetist
Kaiser Permanente Fontana Medical Center, 9961, Sierra Avenue, Fontana, San Bernardino County, California, 92335, United States
NPI: 1508933367

JEREMY S HEINER (CRNA)

Certified Registered Nurse Anesthetist
Kaiser Permanente Fontana Medical Center, 9961, Sierra Avenue, Fontana, San Bernardino County, California, 92335, United States
NPI: 1528127230

JENNIFER L BJERK (CRNA)

Certified Registered Nurse Anesthetist
Baxter Road, Antelope Hills, Murrieta, Riverside County, California, 92593, United States
NPI: 1780743427