KAYLEE JAYNELLE ANKROM
NPI 1104474741
Nurse Practitioner - Family in Bolivar, MO
About Kaylee Jaynelle Ankrom NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KAYLEE JAYNELLE ANKROM (NPI 1104474741) is an individual family provider in Bolivar, Missouri, licensed in Missouri (2019032011) and active in the NPI registry since August 2019. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kaylee Jaynelle Ankrom is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kaylee Ankrom reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Bolivar, MO 65613
- Reassigned Medicare billing, Missouri enrollment
- 249 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 65613 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 11
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BOLIVAR, MO 65613
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 Kaylee Ankrom's NPI number?
The NPI number for Kaylee Ankrom is 1104474741. It was assigned to this individual provider in the NPPES registry on August 27, 2019.
Where is Kaylee Ankrom located?
Kaylee Ankrom practices at 1300 N Oakland Ave, Bolivar, MO 65613. The listed phone number is (417) 326-7676.
What is Kaylee Ankrom's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kaylee Ankrom enrolled in Medicare?
Yes. Kaylee Ankrom is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kaylee Ankrom's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kaylee Ankrom reassigns Medicare benefits to Citizens Memorial Healthcare (Bolivar, MO). 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 Kaylee Ankrom's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kaylee Ankrom accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 3 other insurers list Kaylee Ankrom 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.
When was this NPI record last updated?
The NPPES record for Kaylee Ankrom was last updated on November 27, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.
# Kaylee Jaynelle Ankrom · NPI 1104474741
Family physician in Bolivar, Missouri. Individual provider, active in the CMS NPPES registry since August 27, 2019.
## Identity
- **NPI:** 1104474741 (Entity type: Individual)
- **Enumerated:** August 27, 2019
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 2019032011 (Missouri)
- **Sole proprietor:** No
## Practice location
- **Address:** 1300 N OAKLAND AVE, Bolivar, MO 65613-3018
- **Phone:** (417) 326-7676
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Citizens Memorial Healthcare (NPI 1568566131, Bolivar, MO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 27, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1104474741) · Data from the CMS NPPES public registry.