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SHELLEY JETTE-KELLY PMHNP
NPI 1255012654
Nurse Practitioner - Psychiatric/Mental Health in University Place, WA

Active since July 27, 2023PECOS Enrolled
4113 BRIDGEPORT WAY W STE C2, UNIVERSITY PLACE, WA 98466(253) 234-4566(253) 276-6700 Get Directions Write a Review

NPPES record last updated: July 31, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 31, 2026, May 22, 2026, Feb 6, 2024 and 2 more (5 updates tracked since 2023).

About Shelley Jette-kelly Pmhnp NPPES

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

SHELLEY JETTE-KELLY PMHNP (NPI 1255012654) is an individual psychiatric/mental health provider in University Place, Washington, licensed in Washington (AP61457617) and active in the NPI registry since July 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1255012654
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameSHELLEY JETTE-KELLYCredential: PMHNP
Location Address4113 BRIDGEPORT WAY W STE C2University Place, WA 98466-4325
Mailing Address4113 Bridgeport Way W Ste C2University Place, WA 98466-4325 · (253) 234-4566 · Fax (253) 276-6700
Phone(253) 234-4566
Fax(253) 276-6700
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJuly 27, 2023
Last NPPES UpdateJuly 31, 20265 updates tracked since enumeration
NPPES CertifiedJuly 31, 2026
✔ NPI 1255012654 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in WA · AP61457617
4113 BRIDGEPORT WAY W STE C2, University Place, WA 98466
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shelley Jette-kelly Pmhnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9133603624
PECOS Enrollment IDI20260323003094
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.

Medicare Billing Reassignment

Medicare enrollment records show Shelley Jette-kelly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Shelley Kelly Psychiatric Services LLC
Same address
Psychiatric/Mental Health
4113 BRIDGEPORT WAY W STE C2
University Place, WA 98466
  • Reassigned Medicare billing, Washington enrollment
NPI 1295693828 (253) 234-4566

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 98466 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
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$100.78 typical visit price
range $18.56 – $141.11
Typical copayment $25.19 (range $4.64 – $35.27)
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 2

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

SHELLEY KELLY PSYCHIATRIC SERVICES LLC
Nurse Practitioner (Psychiatric/Mental Health)
4113 BRIDGEPORT WAY W STE C2
UNIVERSITY PLACE, WA 98466
Pierce County (253) 234-4566
MR. DALE PATRICK HELT M.A.
Counselor (Mental Health)
4113 BRIDGEPORT WAY W STE C2
UNIVERSITY PLACE, WA 98466
Pierce County (253) 590-6016

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 Shelley Jette-kelly's NPI number?

The NPI number for Shelley Jette-kelly is 1255012654. It was assigned to this individual provider in the NPPES registry on July 27, 2023.

Where is Shelley Jette-kelly located?

Shelley Jette-kelly practices at 4113 Bridgeport Way W Ste C2, University Place, WA 98466. The listed phone number is (253) 234-4566.

What is Shelley Jette-kelly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Shelley Jette-kelly enrolled in Medicare?

Yes. Shelley Jette-kelly is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Shelley Jette-kelly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shelley Jette-kelly reassigns Medicare benefits to Shelley Kelly Psychiatric Services LLC (University Place, WA). 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 Shelley Jette-kelly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shelley Jette-kelly accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Shelley Jette-kelly 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 Shelley Jette-kelly was last updated on July 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.