KELCY MARIE CARLSON PMHNP-BC
NPI 1124792288
Nurse Practitioner - Psychiatric/Mental Health in Olney, IL
About Kelcy Marie Carlson Pmhnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELCY MARIE CARLSON PMHNP-BC (NPI 1124792288) is an individual psychiatric/mental health provider in Olney, Illinois, licensed in Illinois (209023657) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses
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
Kelcy Marie Carlson Pmhnp-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 Reassignments
2Medicare enrollment records show Kelcy Carlson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Olney, IL 62450
- Reassigned Medicare billing, Illinois enrollment
- 301 clinicians in this Medicare group
Urbana, IL 61801
- Reassigned Medicare billing, Illinois enrollment
- Medicare enrollment name: Carle Health Care Incorporated
- 2,516 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 62450 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 14
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
OLNEY, IL 62450
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 Kelcy Carlson's NPI number?
The NPI number for Kelcy Carlson is 1124792288. It was assigned to this individual provider in the NPPES registry on August 3, 2021.
Where is Kelcy Carlson located?
Kelcy Carlson practices at 363 N West St, Olney, IL 62450. The listed phone number is (618) 392-9400.
What is Kelcy Carlson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Kelcy Carlson enrolled in Medicare?
Yes. Kelcy Carlson 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 organizations bill Medicare for Kelcy Carlson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelcy Carlson reassigns Medicare benefits to 2 organizations: Richland Memorial Hospital, Inc (Olney, IL) and Carle Health Medical Group (Urbana, IL). Each 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 Kelcy Carlson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kelcy Carlson was last updated on August 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Kelcy Marie Carlson, PMHNP-BC · NPI 1124792288
Psychiatric/Mental Health physician in Olney, Illinois. Individual provider, active in the CMS NPPES registry since August 3, 2021.
## Identity
- **NPI:** 1124792288 (Entity type: Individual)
- **Enumerated:** August 3, 2021
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 209023657 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 363 N WEST ST, Olney, IL 62450-1160
- **Phone:** (618) 392-9400
## 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:** 2 organizations under Medicare reassignment (form CMS-855R): Richland Memorial Hospital, Inc (NPI 1326566290, Olney, IL); Carle Health Medical Group (NPI 1154653947, Urbana, IL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** August 3, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1124792288) · Data from the CMS NPPES public registry.