KATHRYN L KELLEY (ACUTE CARE NURSE PRA) – Acute Care Nurse Practitioner, NPI 1205011053

KATHRYN L KELLEY (ACUTE CARE NURSE PRA) is a healthcare provider. based in Shenandoah, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials ACUTE CARE NURSE PRA. They hold a License No. 651221 (TX). The NPI Number for KATHRYN L KELLEY (ACUTE CARE NURSE PRA) is 1205011053

Main info

Female
Sole Proprietor
24 Years Of Experience
Accepts Medicare Assignment
Name
KATHRYN L KELLEY (ACUTE CARE NURSE PRA)
NPI
1205011053
Phone
(936) 270-2099
Address
17201 I H 45 S
Enumeration Date
28 December 2007
Last Update Date
13 March 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2812740148
Graduation Year
2002 (24 years ago)
PAC ID
1052674256
Group Practice PAC ID
4486711744
Professional Enrollment ID
I20180423001816
Address ID
TX774793500SU16605410X401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:18State licenses:2Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for KATHRYN L KELLEY (ACUTE CARE NURSE PRA)

  • 17201 I H 45 S

    SHENANDOAH, TX 773853311

    Phone: (936) 270-2099

    Type: Mailing

  • 6411 Fannin St

    Houston, TX 770301501

    Phone: (713) 704-9780

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $131.

Total Amount is formed as General ($131) + Research ($0) + Ownership ($0) = $131.

Last reported payment date: 2024-12-09 • Largest payer in this snapshot: PFIZER INC. ($80).

Total Amount

$131

General + Research + Ownership

Payments

5

Total payment records

General Amount

$131

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-09

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2018-04-23

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180423001816INurse PractitionerTXTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 77385)

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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: 4486711744View full group profile
NameSpecialtyState
-TX
-TX
Nurse PractitionerTX
Physician AssistantTX
Thoracic Surgery, Vascular SurgeryTX
Medical Oncology, HematologyTX
Internal MedicineTX
General SurgeryNY
G A S T R O E N T E R O L O G YLA
Internal MedicineTX

Reviews

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Frequently asked questions

Does KATHRYN L KELLEY (ACUTE CARE NURSE PRA) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — KATHRYN L KELLEY (ACUTE CARE NURSE PRA) uses 1205011053.
Is KATHRYN L KELLEY (ACUTE CARE NURSE PRA) listed as active for patients and plans?
The listing shows KATHRYN L KELLEY (ACUTE CARE NURSE PRA) as active in the NPI system.
What is KATHRYN L KELLEY (ACUTE CARE NURSE PRA)'s specialty?
The listing groups KATHRYN L KELLEY (ACUTE CARE NURSE PRA) with Acute Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where should I expect KATHRYN L KELLEY (ACUTE CARE NURSE PRA) on a map?
Expect Shenandoah, Texas as a primary anchor for KATHRYN L KELLEY (ACUTE CARE NURSE PRA) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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