MS. NICOLE KELLNER (NP) – Acute Care Nurse Practitioner, NPI 1073914602

MS. NICOLE KELLNER (NP) is a healthcare provider. based in Savannah, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. RN255981 (GA). The NPI Number for MS. NICOLE KELLNER (NP) is 1073914602

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
MS. NICOLE KELLNER (NP)
NPI
1073914602
Phone
(912) 350-8920
Address
4700 Waters Avenue
Enumeration Date
15 September 2014
Last Update Date
13 September 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4148053666
Graduation Year
2014 (12 years ago)
PAC ID
2466672969
Group Practice PAC ID
2668384371
Professional Enrollment ID
I20141006000626
Address ID
WI532263548MI8701XRDXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:11State licenses:2Digital endpointsOther names

9,652 NURSE PRACTITIONER in GA

Provider Addresses for MS. NICOLE KELLNER (NP)

  • 4700 Waters Avenue

    Savannah, GA 31403

    Phone: (912) 350-8920

    Type: Location

  • 9200 W WISCONSIN AVE

    MILWAUKEE, WI 532263522

    Phone: (414) 805-5783

    Fax: (414) 454-0152

    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: 2014-10-06

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20141006000626INurse PractitionerWITBD

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 31403)

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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: 2668384371View full group profile

Reviews

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Frequently asked questions

What NPI should I save for MS. NICOLE KELLNER (NP)?
Save NPI 1073914602 if you need a stable reference for MS. NICOLE KELLNER (NP).
Does this profile mean MS. NICOLE KELLNER (NP) is currently active?
Yes — MS. NICOLE KELLNER (NP) appears active in the national provider directory.
What field does MS. NICOLE KELLNER (NP) work in?
You can think of MS. NICOLE KELLNER (NP) as practicing within Acute Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is MS. NICOLE KELLNER (NP)'s primary listing?
We display Savannah, Georgia because that is what the record indicates for MS. NICOLE KELLNER (NP).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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