KELSEY NICHOLS (FNP-BC) – Family Nurse Practitioner, NPI 1760057723

KELSEY NICHOLS (FNP-BC) is a healthcare provider. based in Fort worth, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-BC. They hold a License No. 1033753 (TX). The NPI Number for KELSEY NICHOLS (FNP-BC) is 1760057723

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
KELSEY NICHOLS (FNP-BC)
NPI
1760057723
Phone
Not provided
Address
4545 BELLAIRE DR S STE 9
Enumeration Date
23 May 2021
Last Update Date
29 August 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8177638300
Graduation Year
2020 (6 years ago)
PAC ID
8325423775
Group Practice PAC ID
0840516662
Professional Enrollment ID
I20220921000827
Address ID
TX761091811FO4545XSXXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for KELSEY NICHOLS (FNP-BC)

  • 4545 BELLAIRE DR S STE 9

    FORT WORTH, TX 761091811

    Phone:

    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: 2022-09-21

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
I20220921000827INurse 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes1915$0
99214Established patient office or other outpatient visit, 30-39 minutes1715$0
View full utilization report →

Insurance plans in this area (ZIP 76109)

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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: 0840516662View full group profile
NameSpecialtyState
-TX
Nurse PractitionerTX
Nurse PractitionerTX
Internal MedicineTX

Reviews

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Frequently asked questions

What identifier follows KELSEY NICHOLS (FNP-BC) across health systems?
The NPI 1760057723 uniquely identifies KELSEY NICHOLS (FNP-BC) in U.S. healthcare data.
Does the public listing show KELSEY NICHOLS (FNP-BC) as active?
KELSEY NICHOLS (FNP-BC)'s NPI record reflects an active status in NPPES.
Which specialty label fits KELSEY NICHOLS (FNP-BC)?
NPPES ties KELSEY NICHOLS (FNP-BC) to Family Nurse Practitioner in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is KELSEY NICHOLS (FNP-BC) tied to Fort Worth, Texas?
If you are local to Fort Worth, Texas, KELSEY NICHOLS (FNP-BC) may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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