KELLY KAVANAUGH (NP) – Family Nurse Practitioner, NPI 1609257005
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
14,984 NURSE PRACTITIONER in OH
Provider Addresses for KELLY KAVANAUGH (NP)
3600 Kolbe Rd
Suite 209
Lorain, OH 440531654
Phone: (440) 960-3237
Fax: (440) 960-3238
Type: Location
PO BOX 636643
CINCINNATI, OH 452636643
Phone: (440) 989-3801
Fax: (440) 960-3238
Type: Mailing
3600 KOLBE RD
SUITE 209
LORAIN, OH 440531654
Phone: (440) 960-3237
Fax: (440) 960-3238
Type: Location
710A LEONA ST
ELYRIA, OH 440352349
Phone: (440) 324-0092
Fax: (440) 324-0093
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $77.
Total Amount is formed as General ($77) + Research ($0) + Ownership ($0) = $77.
Last reported payment date: 2023-05-25 • Largest payer in this snapshot: Lilly USA, LLC ($77).
Total Amount
$77
General + Research + Ownership
Payments
1
Total payment records
General Amount
$77
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $77 |
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: 2015-08-03
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 |
|---|---|---|---|---|
| I20150803001864 | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 44053)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | OH | |
| C H I R O P R A C T I C | OH |
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