STACY JO KENNEDY (FNP- BC) – Family Nurse Practitioner, NPI 1669947610
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
596 NURSE PRACTITIONER in WY
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Provider Addresses for STACY JO KENNEDY (FNP- BC)
191, Overthrust Road, Evanston, Uinta County, Wyoming, 82930, United States
EVANSTON, WY 829309261
Phone: (307) 789-8721
Type: Location
1453A DEWAR DR
ROCK SPRINGS, WY 829015812
Phone: (307) 382-2466
Fax: (888) 395-0359
Type: Location
249, Douglas Drive, North Rock Springs, Sweetwater County, Wyoming, 82901, United States
ROCK SPRINGS, WY 829013148
Phone: (307) 371-1601
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 13 Open Payments records for all available years, with a total value of $228.
Total Amount is formed as General ($228) + Research ($0) + Ownership ($0) = $228.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($138).
Total Amount
$228
General + Research + Ownership
Payments
13
Total payment records
General Amount
$228
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
| Company | Amount |
|---|---|
| Merck Sharp & Dohme LLC | $138 |
| PFIZER INC. | $37 |
| ABBVIE INC. | $31 |
| Actelion Pharmaceuticals US, Inc. | $23 |
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: 2019-03-05
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 |
|---|---|---|---|---|
| I20190305001249 | I | Nurse Practitioner | WY | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 112 | 104 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 42 | 41 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 19 | 19 | $0 |
Insurance plans in this area (ZIP 82930)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | WY | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology) | WY | |
| Physician Assistant | FL | |
| Cardiovascular Disease (Cardiology), Family Practice | WY |
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