KELLY NELSON – Registered Nurse, NPI 1013621192

KELLY NELSON is a healthcare provider. based in Wallingford, Connecticut. specializing in NURSE PRACTITIONER. They hold a License No. 128102 (CT). The NPI Number for KELLY NELSON is 1013621192

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
KELLY NELSON
NPI
1013621192
Phone
Not provided
Address
128 QUIGLEY RD
Enumeration Date
12 January 2023
Last Update Date
12 January 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2037064982
Graduation Year
2023 (3 years ago)
PAC ID
3375087463
Group Practice PAC ID
2769863935
Professional Enrollment ID
I20240701000487
Address ID
CT067083131WA1320XSTXX401

Contacts

Secure Messaging
kelly.nelson@nuvancehealth.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Other namesUpdated within 12 months

4,191 NURSE PRACTITIONER in CT

Provider Addresses for KELLY NELSON

  • 128 QUIGLEY RD

    WALLINGFORD, CT 064925360

    Phone:

    Type: Mailing

  • 34 MAPLE ST

    NORWALK, CT 068503815

    Phone: (203) 852-2501

    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: 2025-08-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20240701000487INurse PractitionerCTTBD
I20250805000528INurse PractitionerMATBD

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 06492)

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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: 2769863935View full group profile
NameSpecialtyState
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerNY
Nurse PractitionerMA
Nurse PractitionerCT
Nurse PractitionerMA
Nurse PractitionerCT
Nurse PractitionerMA
Nurse PractitionerMA
Nurse PractitionerMA

Reviews

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Frequently asked questions

What is the 10-digit NPI for KELLY NELSON?
KELLY NELSON — NPI 1013621192 — is the standard way to identify this listing.
Is KELLY NELSON listed as active for patients and plans?
The listing shows KELLY NELSON as active in the NPI system.
What is KELLY NELSON's specialty?
The listing groups KELLY NELSON with Registered Nurse. Clinical services aligned with this taxonomy classification.
What address line appears for KELLY NELSON?
KELLY NELSON's geographic hint is Wallingford, Connecticut in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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