KELLIE THAXTON – Family Nurse Practitioner, NPI 1669218350

KELLIE THAXTON is a healthcare provider. based in Watkinsville, Georgia. specializing in NURSE PRACTITIONER. They hold a License No. APRN-NP300595 (GA). The NPI Number for KELLIE THAXTON is 1669218350

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
KELLIE THAXTON
NPI
1669218350
Phone
Not provided
Address
1150 GOLDEN WAY
Enumeration Date
2 July 2024
Last Update Date
28 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7066129401
Graduation Year
2024 (2 years ago)
PAC ID
9436697588
Group Practice PAC ID
0446491641
Professional Enrollment ID
I20240820002752
Address ID
GA306777712WA1150XWAYX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

9,658 NURSE PRACTITIONER in GA

Provider Addresses for KELLIE THAXTON

  • 1150 GOLDEN WAY

    WATKINSVILLE, GA 306777712

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $96.

Total Amount is formed as General ($96) + Research ($0) + Ownership ($0) = $96.

Last reported payment date: 2024-10-07 • Largest payer in this snapshot: Bayer Healthcare Pharmaceuticals Inc. ($28).

Total Amount

$96

General + Research + Ownership

Payments

4

Total payment records

General Amount

$96

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-07

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2024-08-20

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
I20240820002752INurse PractitionerGATBD

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 30677)

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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: 0446491641View full group profile
NameSpecialtyState
Nurse PractitionerGA
U R O L O G YGA
U R O L O G YGA
Nurse PractitionerGA
U R O L O G YGA
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerGA
U R O L O G YGA
U R O L O G YGA

Reviews

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Frequently asked questions

What is the standard ID for KELLIE THAXTON in the U.S.?
In the U.S., KELLIE THAXTON is identified by NPI 1669218350.
Quick check: is KELLIE THAXTON active?
Public NPPES data shows KELLIE THAXTON with an active NPI status right now.
What does the directory say KELLIE THAXTON does?
Insurance directories may phrase it differently, but here KELLIE THAXTON maps to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What city is tied to KELLIE THAXTON?
The directory associates KELLIE THAXTON with Watkinsville, Georgia. Check all listed addresses for suites or satellite offices.
Why is information missing for KELLIE THAXTON?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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