KELLY ANDERSON (DNP, APRN-CNP, FNP-C) – Family Nurse Practitioner, NPI 1184481905

KELLY ANDERSON (DNP, APRN-CNP, FNP-C) is a healthcare provider. based in Salt lake city, Utah. specializing in NURSE PRACTITIONER. They hold the professional credentials DNP, APRN-CNP, FNP-C. They hold a License No. 10681922-4405 (UT). The NPI Number for KELLY ANDERSON (DNP, APRN-CNP, FNP-C) is 1184481905

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
KELLY ANDERSON (DNP, APRN-CNP, FNP-C)
NPI
1184481905
Phone
(801) 265-2000
Address
1250 E 3900 S STE 260
Enumeration Date
28 February 2024
Last Update Date
23 December 2025

Doctor Profile

Medical School Name
BAYLOR COLLEGE OF MEDICINE
Secondary Phone
8175764050
Graduation Year
2023 (3 years ago)
PAC ID
8628598489
Group Practice PAC ID
6608157763
Professional Enrollment ID
I20250224001358
Address ID
TX762485691KE2122XDRXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Digital endpointsOther names

2,655 NURSE PRACTITIONER in UT

Provider Addresses for KELLY ANDERSON (DNP, APRN-CNP, FNP-C)

  • 1250 E 3900 S STE 260

    SALT LAKE CITY, UT 841241371

    Phone: (801) 265-2000

    Fax: (801) 265-2008

    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: 2025-11-06

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
I20250224001358INurse PractitionerTXTBD
I20251106002386INurse PractitionerUTTBD

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 84124)

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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: 6608157763View full group profile

Reviews

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Frequently asked questions

Is KELLY ANDERSON (DNP, APRN-CNP, FNP-C) listed with a National Provider Identifier?
Yes — KELLY ANDERSON (DNP, APRN-CNP, FNP-C) has NPI 1184481905 on file in the registry.
Is KELLY ANDERSON (DNP, APRN-CNP, FNP-C) shown as active in public data?
Registry records indicate KELLY ANDERSON (DNP, APRN-CNP, FNP-C) maintains an active NPI.
What kind of doctor is KELLY ANDERSON (DNP, APRN-CNP, FNP-C)?
KELLY ANDERSON (DNP, APRN-CNP, FNP-C) is associated with Family Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.
Is KELLY ANDERSON (DNP, APRN-CNP, FNP-C) associated with Salt Lake City?
Public fields place KELLY ANDERSON (DNP, APRN-CNP, FNP-C) around Salt Lake City, Utah. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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