MRS. KIMBERLY ANN MELLICK MSN, FNP-BC
NPI 1073897930
Nurse Practitioner - Family in Jackson, WY

Active since October 10, 2011PECOS EnrolledAccepts Medicare Assignment
1110 MAPLE WAY, JACKSON, WY 83001(307) 733-7003(307) 734-8477 Get Directions Write a Review

NPPES record last updated: July 24, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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

NPI1073897930
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. KIMBERLY ANN MELLICKCredential: MSN, FNP-BC
Location Address1110 MAPLE WAYJackson, WY 83001
Mailing AddressPo Box 10738Jackson, WY 83002-0738 · (307) 733-7003 · Fax (307) 734-8477
Fax(307) 734-8477
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateOctober 10, 2011
Last NPPES UpdateJuly 24, 2025
NPPES CertifiedJuly 16, 2025
NPI 1073897930 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in WY · 1137
1110 MAPLE WAY, Jackson, WY 83001

Other Identifiers 1

Medicaid121882400WY

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

PECOS PAC ID8921260969
PECOS Enrollment IDI20120508000607
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
28 services24 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
23 services19 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
18 services15 patients

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, WY
5/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number530015
Location625 East BroadwayJackson, WY 83001 · Teton County
Emergency services Birthing friendly

Physician 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.

New Patient
$87.12 typical visit price
range $56.42 – $170.72
Typical copayment $21.78 (range $14.10 – $42.68)
Most-billed visit code 99203
Established Patient
$99.46 typical visit price
range $18.19 – $139.32
Typical copayment $24.86 (range $4.54 – $34.83)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
1110 MAPLE WAY
JACKSON, WY 83001

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.

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 with the weekly NPPES data releases published by CMS.