KELLIE ANN WAHL (NP-C) – Nurse Practitioner, NPI 1013387000
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,106 NURSE PRACTITIONER in MI
Provider Addresses for KELLIE ANN WAHL (NP-C)
10850 E TRAVERSE HWY
STE. 4400
TRAVERSE CITY, MI 496841364
Phone: (231) 346-6800
Fax: (231) 346-6096
Type: Mailing
1000 PAVILLIONS CIR
TRAVERSE CITY, MI 496843198
Phone: (231) 932-3000
Fax: (231) 932-3801
Type: Location
2329 CENTER ST
BOYNE FALLS, MI 497139268
Phone: (231) 535-2822
Fax: (833) 992-2439
Type: Mailing
1108 VALENTINE CIR
CHATTANOOGA, TN 374052866
Phone: (231) 920-5625
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $144.
Total Amount is formed as General ($144) + Research ($0) + Ownership ($0) = $144.
Last reported payment date: 2023-12-12 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($128).
Total Amount
$144
General + Research + Ownership
Payments
2
Total payment records
General Amount
$144
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Pharmaceuticals, Inc | $128 |
| Alkermes, Inc. | $16 |
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: 2017-02-03
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170203000092 | I | Nurse Practitioner | MI | 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 49684)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Interventional Pain Management, Anesthesiology | MI | |
| - | MI | |
| Nurse Practitioner | MI | |
| Mental Health Counselor | MI |
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