KELLIE DAUGHARTY LEWIS (APRN) – Nurse Practitioner, NPI 1750467155
Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for KELLIE DAUGHARTY LEWIS (APRN)
11383 S PORTABELLO RD
SOUTH JORDAN, UT 84095
Phone: (801) 561-8398
Fax: (801) 302-0645
Type: Location
Riverton Post Office, 12760, Sienna Meadow Way, The Meadows, Riverton, Salt Lake County, Utah, 84065, United States
RIVERTON, UT 840651009
Phone: (801) 561-8398
Fax: (801) 302-0645
Type: Mailing
39 WANDERWOOD WAY
SANDY, UT 840924866
Phone: (801) 561-8398
Fax: (801) 302-0645
Type: Location
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 $14.
Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.
Last reported payment date: 2024-01-22 • Largest payer in this snapshot: MERZ NORTH AMERICA, INC. ($14).
Total Amount
$14
General + Research + Ownership
Payments
1
Total payment records
General Amount
$14
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-01-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| MERZ NORTH AMERICA, INC. | $14 |
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: 2003-11-17
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 |
|---|---|---|---|---|
| I20031117000146 | I | Nurse Practitioner | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 100 | 20 | $0 |
| 64555 | Insertion of peripheral nerve neurostimulator electrode through skin | 18 | 18 | $0 |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 17 | 17 | $0 |
| L8679 | Implantable neurostimulator, pulse generator, any type | 15 | 15 | $0 |
Insurance plans in this area (ZIP 84095)
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