DR. ALAN DEWITT KENNETT KELLEY (MD) – Family Medicine Physician, NPI 1558343087
Family Medicine Physician
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
4,141 FAMILY PRACTICE in WA
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Provider Addresses for DR. ALAN DEWITT KENNETT KELLEY (MD)
EvergreenHealth Kirkland, 12040, Northeast 128th Street, Kirkland, King County, Washington, 98034, United States
MS-10
KIRKLAND, WA 980343013
Phone: (425) 899-3270
Fax: (425) 899-3269
Type: Mailing
Redmond Medical Center, 8301, 161st Avenue Northeast, Redmond, King County, Washington, 98052, United States
SUITE 308
REDMOND, WA 980523858
Phone: (425) 882-5020
Fax: (425) 882-5021
Type: Location
20200 54TH AVE W
LYNNWOOD, WA 980366318
Phone: (425) 672-6400
Type: Mailing
13851 HIGHWAY 28
WHITWELL, TN 373975373
Phone: (423) 658-9200
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 $17.
Total Amount is formed as General ($17) + Research ($0) + Ownership ($0) = $17.
Last reported payment date: 2024-06-20 • Largest payer in this snapshot: Bayer Healthcare Pharmaceuticals Inc. ($17).
Total Amount
$17
General + Research + Ownership
Payments
1
Total payment records
General Amount
$17
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Bayer Healthcare Pharmaceuticals Inc. | $17 |
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: 2025-07-21
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250721000097 | I | Family Practice | TN | 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 98034)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | AL | |
| Nurse Practitioner | TN | |
| General Practice | TN |
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