KELLY J BLICKENSDERFER (CFNP) – Nurse Practitioner, NPI 1528145026
Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
14,984 NURSE PRACTITIONER in OH
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Provider Addresses for KELLY J BLICKENSDERFER (CFNP)
745, Haskins Road, Boom Town Historic District, Quail Hollow, Bowling Green, Wood County, Ohio, 43402, United States
SUITE B
BOWLING GREEN, OH 434021637
Phone: (419) 353-7069
Fax: (419) 353-7076
Type: Mailing
1215, Ridgewood Drive, Foxgate Farm, Westgate Homes, Bowling Green, Wood County, Ohio, 43402, United States
SUITE B
BOWLING GREEN, OH 434022690
Phone: (419) 352-9071
Fax: (419) 352-9073
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 83 Open Payments records for all available years, with a total value of $1,422.
Total Amount is formed as General ($1,422) + Research ($0) + Ownership ($0) = $1,422.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: ABBVIE INC. ($211).
Total Amount
$1,422
General + Research + Ownership
Payments
83
Total payment records
General Amount
$1,422
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $211 |
| PFIZER INC. | $201 |
| Novo Nordisk Inc | $158 |
| AstraZeneca Pharmaceuticals LP | $149 |
| Lilly USA, LLC | $110 |
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: 2008-09-19
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 |
|---|---|---|---|---|
| I20080919000149 | I | Nurse Practitioner | OH | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 308 | 169 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 152 | 115 | $0 |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 99 | 16 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 88 | 88 | $0 |
| 99439 | Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month | 44 | 11 | $0 |
Insurance plans in this area (ZIP 43402)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | OH | 90670 | Pneumococcal vaccine for injection into muscle | 12 | 12 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| Family Practice | OH | |
| Sports Medicine, Family Practice | OH | |
| - | OH | |
| Critical Care (Intensivists), Pulmonary Disease | NY | |
| - | OH | |
| - | OH | |
| General Surgery | OH |
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