MS. SHAWDARE MIRIAM KELLY (FNP) – Family Nurse Practitioner, NPI 1902310618

MS. SHAWDARE MIRIAM KELLY (FNP) is a healthcare provider. based in Dresden, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 021982 (OH). The NPI Number for MS. SHAWDARE MIRIAM KELLY (FNP) is 1902310618

Main info

Female
Sole Proprietor
9 Years Of Experience
Accepts Medicare Assignment
Name
MS. SHAWDARE MIRIAM KELLY (FNP)
NPI
1902310618
Phone
(740) 624-8563
Address
914 HIGH ST
Enumeration Date
17 November 2017
Last Update Date
17 November 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7404398900
Graduation Year
2017 (9 years ago)
PAC ID
2567721665
Group Practice PAC ID
8729032966
Professional Enrollment ID
I20180118000647
Address ID
OH437259614CA1341XSTXX300
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

14,984 NURSE PRACTITIONER in OH

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Provider Addresses for MS. SHAWDARE MIRIAM KELLY (FNP)

  • 914, High Street, Dresden, Muskingum County, Ohio, 43821, United States

    DRESDEN, OH 438219782

    Phone: (740) 624-8563

    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: 2018-02-06

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180118000647INurse PractitionerOHTBD
I20180206000876INurse PractitionerWVTBD

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
99285Emergency department visit with high level of medical decision making6866$0
99284Emergency department visit with moderate level of medical decision making5451$0
99291Critical care, first 30-74 minutes2626$0
View full utilization report →

Insurance plans in this area (ZIP 43821)

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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: 8729032966View full group profile
NameSpecialtyState
Emergency MedicineOH
Mental Health CounselorWV
Emergency MedicineOH
-VA
Internal MedicineOH
Emergency MedicineSC
Internal MedicineMI
Nurse PractitionerOH
Mental Health CounselorWV
Internal Medicine, HospitalistOH

Reviews

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Frequently asked questions

What is the standard ID for MS. SHAWDARE MIRIAM KELLY (FNP) in the U.S.?
In the U.S., MS. SHAWDARE MIRIAM KELLY (FNP) is identified by NPI 1902310618.
Should I treat MS. SHAWDARE MIRIAM KELLY (FNP) as an active provider?
Patients and plans typically see MS. SHAWDARE MIRIAM KELLY (FNP) as active in the national extract.
What services align with MS. SHAWDARE MIRIAM KELLY (FNP)'s listing?
MS. SHAWDARE MIRIAM KELLY (FNP)'s public classification highlights Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is MS. SHAWDARE MIRIAM KELLY (FNP) tied to Dresden, Ohio?
If you are local to Dresden, Ohio, MS. SHAWDARE MIRIAM KELLY (FNP) may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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