KELLY J CAMPBELL (FNP) – Family Nurse Practitioner, NPI 1366874794

KELLY J CAMPBELL (FNP) is a healthcare provider. based in Indianapolis, Indiana. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 71004584A (IN). The NPI Number for KELLY J CAMPBELL (FNP) is 1366874794

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
KELLY J CAMPBELL (FNP)
NPI
1366874794
Phone
Not provided
Address
10330 N MERIDIAN ST # 300
Enumeration Date
8 August 2013
Last Update Date
6 June 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7655840339
Graduation Year
2013 (13 years ago)
PAC ID
0840426433
Group Practice PAC ID
7012047640
Professional Enrollment ID
I20131204002139
Address ID
IN473949436WI473XXAVEX400

Contacts

Secure Messaging
kelly.campbell.1@7598.direct.athenahealth.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness85
Years active:12State licenses:1Other namesUpdated within 12 months

8,192 NURSE PRACTITIONER in IN

Provider Addresses for KELLY J CAMPBELL (FNP)

  • 10330 N MERIDIAN ST # 300

    INDIANAPOLIS, IN 462901024

    Phone:

    Type: Mailing

  • 409 E GREENVILLE AVE

    SUITE 300

    WINCHESTER, IN 473949436

    Phone: (765) 584-0480

    Type: Location

  • 409 SE GREENVILLE AVE

    WINCHESTER, IN 473949464

    Phone:

    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: 2013-12-04

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
I20131204002139INurse PractitionerINTBD

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
83036Hemoglobin a1c level2520$0
81003Automated urinalysis test1715$0
View full utilization report →

Insurance plans in this area (ZIP 46290)

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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: 7012047640View full group profile
NameSpecialtyState
Nurse PractitionerIN
-IN
Pulmonary Disease, Critical Care (Intensivists)IN
General Surgery, Thoracic SurgeryIN
-IN
-NY
Interventional RadiologyIN
-IN
G A S T R O E N T E R O L O G YTX
Nurse PractitionerIN

Reviews

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Frequently asked questions

How do I look up KELLY J CAMPBELL (FNP) by NPI?
Use NPI 1366874794 when you need to reference KELLY J CAMPBELL (FNP) in forms, claims, or directories.
Is KELLY J CAMPBELL (FNP) currently active in the NPI registry?
CMS-published data lists KELLY J CAMPBELL (FNP) as an active registrant.
What kind of provider is KELLY J CAMPBELL (FNP)?
The page reflects Family Nurse Practitioner for KELLY J CAMPBELL (FNP). Clinical services aligned with this taxonomy classification.
What location metadata exists for KELLY J CAMPBELL (FNP)?
The page summarizes Indianapolis, Indiana for KELLY J CAMPBELL (FNP); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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