KELLIE JO ENDERSON (ARNP) – General Practice Physician, NPI 1316523459
General Practice Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,541 NURSE PRACTITIONER in IA
Provider Addresses for KELLIE JO ENDERSON (ARNP)
302 E 3RD ST
HUXLEY, IA 501249450
Phone: (515) 202-7279
Type: Location
27450 YNEZ RD
TEMECULA, CA 925914671
Phone: (951) 383-4333
Fax: (951) 506-2361
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $21.
Total Amount is formed as General ($21) + Research ($0) + Ownership ($0) = $21.
Last reported payment date: 2023-08-14 • Largest payer in this snapshot: Medtronic, Inc. ($21).
Total Amount
$21
General + Research + Ownership
Payments
1
Total payment records
General Amount
$21
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $21 |
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: 2021-12-03
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20211203001312 | I | Nurse Practitioner | IA | TBD |
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.
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 50124)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | IA | |
| Internal Medicine | IA | |
| Emergency Medicine | IA | |
| Family Practice | IA | |
| Nurse Practitioner | UT | |
| Family Practice | SC | |
| General Surgery | IA | |
| Physician Assistant | WA | |
| Physician Assistant | IA | |
| - | IA |
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