KELCIE PETTY – Physician Assistant, NPI 1497498059
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,972 PHYSICIAN ASSISTANT in UT
Provider Addresses for KELCIE PETTY
1806 N DIXIE DOWNS RD UNIT 45
ST GEORGE, UT 847705657
Phone: (801) 867-1971
Type: Mailing
110 W 1325 N STE 200
CEDAR CITY, UT 847218179
Phone: (435) 586-7676
Type: Mailing
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 $18.
Total Amount is formed as General ($18) + Research ($0) + Ownership ($0) = $18.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: Lundbeck LLC ($18).
Total Amount
$18
General + Research + Ownership
Payments
1
Total payment records
General Amount
$18
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lundbeck LLC | $18 |
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: 2025-02-25
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 |
|---|---|---|---|---|
| I20250225003988 | I | Physician Assistant | UT | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84770)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | TX | |
| Family Practice, Sports Medicine | UT | |
| Physician Assistant | UT | |
| Physician Assistant | UT | |
| Physician Assistant | UT | |
| Family Practice | UT | |
| Physician Assistant | UT | |
| - | UT | |
| Family Practice, Obstetrics/Gynecology | UT | |
| Physician Assistant | UT |
Reviews
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