KELLY L NICKELSON (PHYSICAL THERAPIST) – Physical Therapist, NPI 1871780155
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,533 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MO
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Provider Addresses for KELLY L NICKELSON (PHYSICAL THERAPIST)
401, Gaylord Drive, Fulton, Callaway County, Missouri, 65251, United States
FULTON, MO 652512517
Phone: (573) 642-8541
Fax: (573) 642-8500
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.
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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: 2008-04-01
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 |
|---|---|---|---|---|
| I20080401000223 | I | Physical Therapist In Private Practice | MO | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 1,051 | 66 | $0 |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 602 | 61 | $0 |
| 97530 | Therapy procedure using functional activities | 495 | 72 | $0 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | 177 | 38 | $0 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 115 | 28 | $0 |
Insurance plans in this area (ZIP 65251)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Hospitalist, Internal Medicine | MO | |
| Nurse Practitioner | MO | |
| Physical Therapist In Private Practice | MO | |
| - | WI | |
| Infectious Disease, Hospitalist, Internal Medicine | NM | |
| Internal Medicine, Hospitalist | MO | |
| - | MO |
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