KELLY ANNE ELLISON – Family Nurse Practitioner, NPI 1265823843
Family Nurse Practitioner
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
Provider Addresses for KELLY ANNE ELLISON
2000 S FM 51
DECATUR, TX 762343702
Phone: (940) 683-0300
Fax: (940) 683-0491
Type: Mailing
1905 DOCTORS HOSPITAL DR
BRIDGEPORT, TX 764262260
Phone: (940) 683-0300
Fax: (940) 683-0491
Type: Location
125 DAVIS BLVD
SOUTHLAKE, TX 760928209
Phone: (682) 212-9104
Type: Mailing
125 Davis Blvd
Southlake, TX 760928209
Phone: (682) 212-9104
Type: Location
1980 S MAIN ST
WEATHERFORD, TX 760865508
Phone: (817) 598-5616
Type: Location
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 $27.
Total Amount is formed as General ($27) + Research ($0) + Ownership ($0) = $27.
Last reported payment date: 2024-03-15 • Largest payer in this snapshot: SK Life Science, Inc. ($27).
Total Amount
$27
General + Research + Ownership
Payments
1
Total payment records
General Amount
$27
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| SK Life Science, Inc. | $27 |
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: 2015-04-15
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 |
|---|---|---|---|---|
| I20150415000732 | I | Nurse Practitioner | TX | 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 |
|---|---|---|---|---|
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 180 | 180 | $0 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 176 | 19 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 147 | 130 | $0 |
| 81003 | Automated urinalysis test | 43 | 41 | $0 |
| 87880 | Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) | 38 | 37 | $0 |
Insurance plans in this area (ZIP 76234)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| Physician Assistant | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | MS | |
| Nurse Practitioner | TX | |
| Physician Assistant | TX |
Reviews
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