MRS. KELSEY MARIE KINNEMAN (A-GNP-C) – Family Nurse Practitioner, NPI 1336655539

MRS. KELSEY MARIE KINNEMAN (A-GNP-C) is a healthcare provider. based in Fredericktown, Missouri. specializing in NURSE PRACTITIONER. They hold the professional credentials A-GNP-C. They hold a License No. 2017044039 (MO). The NPI Number for MRS. KELSEY MARIE KINNEMAN (A-GNP-C) is 1336655539

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
MRS. KELSEY MARIE KINNEMAN (A-GNP-C)
NPI
1336655539
Phone
(573) 561-2300
Address
355 N CHAMBER DR
Enumeration Date
26 December 2017
Last Update Date
26 December 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5735612300
Graduation Year
2017 (9 years ago)
PAC ID
3072871763
Group Practice PAC ID
6103051412
Professional Enrollment ID
I20180102001021
Address ID
MO636451348FR115XXAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

7,023 NURSE PRACTITIONER in MO

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Provider Addresses for MRS. KELSEY MARIE KINNEMAN (A-GNP-C)

  • 355, North Chamber Drive, Fredericktown, Madison County, Missouri, 63645, United States

    FREDERICKTOWN, MO 636457947

    Phone: (573) 561-2300

    Fax: (573) 561-2302

    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)

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: 2018-01-02

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
I20180102001021INurse 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes290160$0
36415Insertion of needle into vein for collection of blood sample260154$0
82044Urine microalbumin (protein) analysis11494$0
99213Established patient office or other outpatient visit, 20-29 minutes8766$0
G0442Annual alcohol misuse screening, 5 to 15 minutes5555$0
View full utilization report →

Insurance plans in this area (ZIP 63645)

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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: 6103051412View full group profile
NameSpecialtyState
Family PracticeMO

Reviews

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Frequently asked questions

How do payers reference MRS. KELSEY MARIE KINNEMAN (A-GNP-C)?
For MRS. KELSEY MARIE KINNEMAN (A-GNP-C), use NPI 1336655539 as the unique 10-digit identifier.
Is there an active status for MRS. KELSEY MARIE KINNEMAN (A-GNP-C)?
For scheduling context, MRS. KELSEY MARIE KINNEMAN (A-GNP-C) is shown as active in the registry.
What clinical focus is listed for MRS. KELSEY MARIE KINNEMAN (A-GNP-C)?
At a glance, MRS. KELSEY MARIE KINNEMAN (A-GNP-C) is tied to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MRS. KELSEY MARIE KINNEMAN (A-GNP-C)?
Travel planning: use Fredericktown, Missouri as the reference point for MRS. KELSEY MARIE KINNEMAN (A-GNP-C), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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