KELLY M WATSON FNP
NPI 1154711265
Nurse Practitioner - Family in Bolivar, MO

Q: What is Kelly Watson's NPI number?

The NPI number for Kelly Watson is 1154711265. It was assigned to this individual provider in the NPPES registry on January 27, 2015.

Q: What is Kelly Watson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Watson was last updated on January 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since January 27, 2015PECOS EnrolledAccepts Medicare Assignment

1500 N OAKLAND AVE, BOLIVAR, MO 65613(417) 328-4201(417) 326-3939 Get Directions Write a Review

NPPES record last updated: January 19, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 19, 2026, Apr 23, 2021 (2 updates tracked since 2021).

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About Kelly M Watson Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY M WATSON FNP (NPI 1154711265) is an individual family provider in Bolivar, Missouri, licensed in Missouri (2016007903) and active in the NPI registry since January 2015. She is enrolled in Medicare PECOS, is affiliated with Citizens Memorial Hospital, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1154711265

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameKELLY M WATSONCredential: FNP

Location Address1500 N OAKLAND AVEBolivar, MO 65613-3099

Mailing Address22742 Midland DrShawnee, KS 66226-3553 · (913) 441-2293

Phone(417) 328-4201

Fax(417) 326-3939

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateJanuary 27, 2015

Last NPPES UpdateJanuary 19, 20262 updates tracked since enumeration

NPPES CertifiedJanuary 19, 2026

✔ NPI 1154711265 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 MO · 2016007903

1500 N OAKLAND AVE, Bolivar, MO 65613

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, UnitedHealthcare.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

Kelly M Watson Fnp 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 ID1951627694

PECOS Enrollment IDI20160504001148

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Citizens Memorial Hospital

Acute Care Hospitals · Bolivar, MO

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number260195

Location1500 N OaklandBolivar, MO 65613 · Polk County

Emergency services Birthing friendly

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.

New Patient

$81.64 typical visit price

range $52.28 – $161.24

Typical copayment $20.41 (range $13.07 – $40.31)

Most-billed visit code 99203

Established Patient

$93.24 typical visit price

range $16.30 – $131.05

Typical copayment $23.31 (range $4.07 – $32.76)

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 20

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

JACOB PODLESKI

Anesthesiology