MRS. KIMBERLY ANN MELLICK MSN, FNP-BC
NPI 1073897930
Nurse Practitioner - Family in Jackson, WY
About Mrs. Kimberly Ann Mellick Msn, Fnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. KIMBERLY ANN MELLICK MSN, FNP-BC (NPI 1073897930) is an individual family provider in Jackson, Wyoming, licensed in Wyoming (1137) and active in the NPI registry since October 2011. She is enrolled in Medicare PECOS, is affiliated with St Johns Medical Center, and is a graduate of Other (2011).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Kimberly Ann Mellick Msn, Fnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Kimberly Mellick reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Jackson, WY 83001
- Reassigned Medicare billing, Wyoming enrollment
- 2 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 3
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
St Johns Medical Center
Acute Care Hospitals · Jackson, WYPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 83001 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kimberly Mellick's NPI number?
The NPI number for Kimberly Mellick is 1073897930. It was assigned to this individual provider in the NPPES registry on October 10, 2011.
Where is Kimberly Mellick located?
Kimberly Mellick practices at 1110 Maple Way, Jackson, WY 83001. The listed phone number is (307) 733-7003.
What is Kimberly Mellick's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kimberly Mellick enrolled in Medicare?
Yes. Kimberly Mellick is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Kimberly Mellick's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Mellick reassigns Medicare benefits to Jackson Whole Family Health, Inc. (Jackson, WY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kimberly Mellick's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kimberly Mellick accept?
Health plans from Blue Cross Blue Shield of Wyoming and UnitedHealthcare list Kimberly Mellick as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Kimberly Mellick affiliated with any hospitals?
According to CMS data, Kimberly Mellick is affiliated with St Johns Medical Center.
When was this NPI record last updated?
The NPPES record for Kimberly Mellick was last updated on July 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Kimberly Ann Mellick, MSN, FNP-BC · NPI 1073897930
Family physician in Jackson, Wyoming. Individual provider, active in the CMS NPPES registry since October 10, 2011.
## Identity
- **NPI:** 1073897930 (Entity type: Individual)
- **Enumerated:** October 10, 2011
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 1137 (Wyoming)
- **Sole proprietor:** No
## Practice location
- **Address:** 1110 MAPLE WAY, Jackson, WY 83001
- **Phone:** (307) 733-7003 · **Fax:** (307) 734-8477
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Jackson Whole Family Health, Inc. (NPI 1053519918, Jackson, WY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2011
## Record status
- **NPPES last updated:** July 24, 2025
- **Other identifiers:** Medicaid 121882400 (WY)
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Source: [NPI Profile](https://npiprofile.com/npi/1073897930) · Data from the CMS NPPES public registry.