KELSEY BYWATER (FNP) – Family Nurse Practitioner, NPI 1629508403

KELSEY BYWATER (FNP) is a healthcare provider. based in Brigham city, Utah. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 337245-3102 (UT). The NPI Number for KELSEY BYWATER (FNP) is 1629508403

Main info

Female
Sole Proprietor
9 Years Of Experience
Accepts Medicare Assignment
Name
KELSEY BYWATER (FNP)
NPI
1629508403
Phone
(435) 723-5248
Address
984 MEDICAL DR STE 1
Enumeration Date
14 June 2017
Last Update Date
17 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4357235248
Graduation Year
2017 (9 years ago)
PAC ID
6204106230
Group Practice PAC ID
9931000460
Professional Enrollment ID
I20170724002173
Address ID
UT843024712BR984XXDRXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness85
Years active:8State licenses:1Digital endpointsOther names

2,655 NURSE PRACTITIONER in UT

Provider Addresses for KELSEY BYWATER (FNP)

  • 984 MEDICAL DR STE 1

    BRIGHAM CITY, UT 843024712

    Phone: (435) 723-5248

    Fax: (877) 395-5866

    Type: Location

  • 1041 S MEDICAL DR STE 200

    BRIGHAM CITY, UT 843023293

    Phone: (435) 723-5248

    Fax: (435) 723-5240

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 78 Open Payments records for all available years, with a total value of $1,213.

Total Amount is formed as General ($1,213) + Research ($0) + Ownership ($0) = $1,213.

Last reported payment date: 2024-12-11 • Largest payer in this snapshot: ABBVIE INC. ($393).

Total Amount

$1,213

General + Research + Ownership

Payments

78

Total payment records

General Amount

$1,213

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-11

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: 2017-07-24

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
I20170724002173INurse 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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes192104$0
99213Established patient office or other outpatient visit, 20-29 minutes10888$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit4747$0
83036Hemoglobin a1c level4034$0
81003Automated urinalysis test3023$0
View full utilization report →

Insurance plans in this area (ZIP 84302)

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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: 9931000460View full group profile
NameSpecialtyState
Family PracticeUT
Nurse PractitionerUT
Nurse PractitionerUT
Family PracticeID
Nurse PractitionerUT
Nurse PractitionerUT
Internal MedicineUT
Family PracticeUT
Family PracticeUT
Physician AssistantVA

Reviews

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Frequently asked questions

What number should I use to identify KELSEY BYWATER (FNP) for billing?
Administrative and clinical systems typically use NPI 1629508403 for KELSEY BYWATER (FNP).
Is KELSEY BYWATER (FNP) currently accepting referrals based on NPI status?
Registry metadata lists KELSEY BYWATER (FNP) as active.
What type of care does KELSEY BYWATER (FNP) provide?
KELSEY BYWATER (FNP)'s profile centers on Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What city is tied to KELSEY BYWATER (FNP)?
The directory associates KELSEY BYWATER (FNP) with Brigham City, Utah. Check all listed addresses for suites or satellite offices.
Who maintains KELSEY BYWATER (FNP)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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