STACEY L. KELLEY (FNP-C) – Family Nurse Practitioner, NPI 1033188263

STACEY L. KELLEY (FNP-C) is a healthcare provider. based in South portland, Maine. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. CNP81415 (ME). The NPI Number for STACEY L. KELLEY (FNP-C) is 1033188263

Main info

Female
25 Years Of Experience
Accepts Medicare Assignment
Name
STACEY L. KELLEY (FNP-C)
NPI
1033188263
Phone
(207) 482-7800
Address
324 GANNETT DR STE 200
Enumeration Date
17 March 2006
Last Update Date
10 November 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2078282101
Graduation Year
2001 (25 years ago)
PAC ID
1557398245
Group Practice PAC ID
8224566138
Professional Enrollment ID
I20050725000763
Address ID
ME041022603PO33XXXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,869 NURSE PRACTITIONER in ME

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Provider Addresses for STACEY L. KELLEY (FNP-C)

  • Gannett Drive, South Portland, Cumberland County, Maine, 04092, United States

    SOUTH PORTLAND, ME 041063266

    Phone: (207) 482-7800

    Type: Mailing

  • Maine Medical Center, 22, Bramhall Street, West End, Portland, Cumberland County, Maine, 04102, United States

    PORTLAND, ME 041023134

    Phone: (207) 662-2526

    Type: Location

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 $76.

Total Amount is formed as General ($76) + Research ($0) + Ownership ($0) = $76.

Last reported payment date: 2024-01-09 • Largest payer in this snapshot: Lilly USA, LLC ($76).

Total Amount

$76

General + Research + Ownership

Payments

1

Total payment records

General Amount

$76

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-09

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Lilly USA, LLC$76
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: 2005-07-25

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
I20050725000763INurse PractitionerMETBD

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 04106)

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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: 8224566138View full group profile
NameSpecialtyState
Physical Medicine And RehabilitationCO
Occupational Therapist In Private PracticeCO
Orthopedic SurgeryMA
Sports MedicineME
Hand Surgery, Orthopedic SurgeryME
Physician AssistantNH
Physical Therapist In Private PracticeME
Physical Therapist In Private PracticeME
Physical Therapist In Private PracticeME
Physical Therapist In Private PracticeME

Reviews

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Frequently asked questions

What federal number belongs to STACEY L. KELLEY (FNP-C)?
The federal identifier for STACEY L. KELLEY (FNP-C) is NPI 1033188263.
Is STACEY L. KELLEY (FNP-C) active in the national directory?
STACEY L. KELLEY (FNP-C)'s public NPI profile is in an active state.
What kind of provider is STACEY L. KELLEY (FNP-C)?
The page reflects Family Nurse Practitioner for STACEY L. KELLEY (FNP-C). Clinical services aligned with this taxonomy classification.
What location metadata exists for STACEY L. KELLEY (FNP-C)?
The page summarizes South Portland, Maine for STACEY L. KELLEY (FNP-C); expand the address list for detail.
What if South Portland, Maine seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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