KAYLEE JAYNELLE ANKROM – Family Nurse Practitioner, NPI 1104474741

KAYLEE JAYNELLE ANKROM is a healthcare provider. based in Bolivar, Missouri. specializing in Family Nurse Practitioner. They hold a License No. 2019032011 (MO). The NPI Number for KAYLEE JAYNELLE ANKROM is 1104474741

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
KAYLEE JAYNELLE ANKROM
NPI
1104474741
Phone
Not provided
Address
1300 N OAKLAND AVE
Enumeration Date
27 August 2019
Last Update Date
27 November 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4173286040
Graduation Year
2019 (7 years ago)
PAC ID
6406188994
Group Practice PAC ID
4183528169
Professional Enrollment ID
I20191104000053

Contacts

Secure Messaging
kaylee.ankrom@citizensmemorial.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:6State licenses:1Other namesUpdated within 12 months

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Provider Addresses for KAYLEE JAYNELLE ANKROM

  • 1300, North Oakland Avenue, Bolivar, Polk County, Missouri, 65613, United States

    BOLIVAR, MO 656133018

    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 56 Open Payments records for all available years, with a total value of $930.

Total Amount is formed as General ($930) + Research ($0) + Ownership ($0) = $930.

Last reported payment date: 2024-12-06 • Largest payer in this snapshot: Lilly USA, LLC ($141).

Total Amount

$930

General + Research + Ownership

Payments

56

Total payment records

General Amount

$930

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-06

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: 2019-11-04

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20191104000053INurse PractitionerMOTBD

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 65613)

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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: 4183528169View full group profile

Reviews

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Frequently asked questions

What is KAYLEE JAYNELLE ANKROM's NPI number?
KAYLEE JAYNELLE ANKROM's NPI is 1104474741 — the number used across U.S. healthcare to identify this provider.
Is KAYLEE JAYNELLE ANKROM still an active registrant?
KAYLEE JAYNELLE ANKROM carries an active NPI according to the public dataset.
What clinical focus is listed for KAYLEE JAYNELLE ANKROM?
At a glance, KAYLEE JAYNELLE ANKROM is tied to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for KAYLEE JAYNELLE ANKROM?
Travel planning: use Bolivar, Missouri as the reference point for KAYLEE JAYNELLE ANKROM, then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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