EMILEE KELLY (AGNP) – Adult Health Nurse Practitioner, NPI 1205688421

EMILEE KELLY (AGNP) is a healthcare provider. based in Sandy, Utah. specializing in NURSE PRACTITIONER. They hold the professional credentials AGNP. They hold a License No. 6925143-3102 (UT). The NPI Number for EMILEE KELLY (AGNP) is 1205688421

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
EMILEE KELLY (AGNP)
NPI
1205688421
Phone
(801) 253-6886
Address
9980 S 300 W STE 300
Enumeration Date
2 April 2024
Last Update Date
2 April 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8012536886
Graduation Year
2023 (3 years ago)
PAC ID
5193164663
Group Practice PAC ID
2062778160
Professional Enrollment ID
I20240416003918
Address ID
UT847908147ST2019XDRXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:2State licenses:2Digital endpointsOther names

2,655 NURSE PRACTITIONER in UT

Provider Addresses for EMILEE KELLY (AGNP)

  • 9980 S 300 W STE 300

    SANDY, UT 840703654

    Phone: (801) 253-6886

    Fax: (385) 900-5928

    Type: Mailing

  • 2019 E RIVERSIDE DR STE A101

    ST GEORGE, UT 847908147

    Phone: (801) 253-6886

    Type: Location

  • 9980 S 300 W Ste 300

    Sandy, UT 840703654

    Phone: (018) 273-0100

    Fax: (385) 900-5928

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 8 Open Payments records for all available years, with a total value of $1,805.

Total Amount is formed as General ($1,805) + Research ($0) + Ownership ($0) = $1,805.

Last reported payment date: 2024-10-03 • Largest payer in this snapshot: Solventum Corporation ($1,547).

Total Amount

$1,805

General + Research + Ownership

Payments

8

Total payment records

General Amount

$1,805

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-03

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: 2025-07-18

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
I20240416003918INurse PractitionerUTTBD
I20250718003517INurse PractitionerAZTBD

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 84070)

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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: 2062778160View full group profile
NameSpecialtyState
P O D I A T R YCA
P O D I A T R YUT
P O D I A T R YUT
P O D I A T R YUT
P O D I A T R YUT
P O D I A T R YAK

Reviews

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Frequently asked questions

Where can patients find EMILEE KELLY (AGNP)'s NPI?
You can confirm EMILEE KELLY (AGNP) with NPI 1205688421; it appears in the national provider directory.
Is EMILEE KELLY (AGNP) active in the national directory?
EMILEE KELLY (AGNP)'s public NPI profile is in an active state.
Does EMILEE KELLY (AGNP) list a primary specialty?
If you are matching referrals, note Adult Health Nurse Practitioner for EMILEE KELLY (AGNP). Clinical services aligned with this taxonomy classification.
What location shows for EMILEE KELLY (AGNP)?
We surface Sandy, Utah for EMILEE KELLY (AGNP) based on available NPPES addresses.
What if Sandy, Utah seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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