STACY KELLUM (FNP-C) – Family Nurse Practitioner, NPI 1740865914
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
953 FAMILY PRACTICE in NE
Provider Addresses for STACY KELLUM (FNP-C)
233 S 13TH ST STE 1100
LINCOLN, NE 685082003
Phone: (720) 897-3749
Type: Location
527 N 5TH ST
ONEILL, NE 687631327
Phone: (402) 540-1804
Type: Mailing
527 N 5th St
ONeill, NE 687631327
Phone: (402) 540-1804
Type: Location
699 Walnut St Ste 4
Des Moines, IA 503093949
Phone: (720) 897-3749
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 23 Open Payments records for all available years, with a total value of $235.
Total Amount is formed as General ($235) + Research ($0) + Ownership ($0) = $235.
Last reported payment date: 2024-06-20 • Largest payer in this snapshot: ABBVIE INC. ($235).
Total Amount
$235
General + Research + Ownership
Payments
23
Total payment records
General Amount
$235
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $235 |
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: 2025-11-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20251110002332 | I | Family Practice | NE | TBD |
| I20251112003205 | I | Family Practice | AZ | 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 68508)
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