JENNY LYNN KELLY APNP
NPI 1174872600
Nurse Practitioner - Family in Green Bay, WI

Q: What is Jenny Kelly's NPI number?

The NPI number for Jenny Kelly is 1174872600. It was assigned to this individual provider in the NPPES registry on August 30, 2012.

Q: What is Jenny Kelly'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 Jenny Kelly was last updated on November 5, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 30, 2012PECOS Enrolled

2845 GREENBRIER RD, GREEN BAY, WI 54311(920) 288-4060(920) 288-4067 Get Directions Write a Review

NPPES record last updated: November 5, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Jenny Lynn Kelly Apnp NPPES

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

JENNY LYNN KELLY APNP (NPI 1174872600) is an individual family provider in Green Bay, Wisconsin, licensed in Wisconsin (4936-33) and active in the NPI registry since August 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174872600

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameJENNY LYNN KELLYCredential: APNP

Location Address2845 GREENBRIER RDGreen Bay, WI 54311-6519

Mailing Address164 N BroadwayGreen Bay, WI 54303-2728 · (920) 965-4055 · Fax (920) 405-5388

Phone(920) 288-4060

Fax(920) 288-4067

Sole ProprietorNo

Enumeration DateAugust 30, 2012

Last NPPES UpdateNovember 5, 2013

✔ NPI 1174872600 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 WI · 4936-33

2845 GREENBRIER RD, Green Bay, WI 54311

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Other Identifiers 1

Medicaid1174872600WI

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jenny Lynn Kelly Apnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54311 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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.

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