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MRS. KELLI ANN VICKREY FNP-C
NPI 1255984837
Nurse Practitioner - Family in Fort Worth, TX

Active since July 22, 2019Opted out of Medicare · through Apr 6, 2028
6440 RENDON BLOODWORTH RD, FORT WORTH, TX 76140(817) 662-2550(817) 612-3214 Get Directions Write a Review

NPPES record last updated: May 9, 2023. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: May 9, 2023, Jul 22, 2019 (2 updates tracked since 2019).

About Mrs. Kelli Ann Vickrey Fnp-c NPPES

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

MRS. KELLI ANN VICKREY FNP-C (NPI 1255984837) is an individual family provider in Fort Worth, Texas, licensed in Texas (AP142103) and active in the NPI registry since July 2019. She has opted out of Medicare through April 6, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1255984837
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. KELLI ANN VICKREYCredential: FNP-C
Location Address6440 RENDON BLOODWORTH RDFort Worth, TX 76140-9448
Mailing Address6440 Rendon Bloodworth RdFort Worth, TX 76140-9448 · (817) 662-2550 · Fax (817) 612-3214
Phone(817) 662-2550
Fax(817) 612-3214
Sole ProprietorNo
Enumeration DateJuly 22, 2019
Last NPPES UpdateMay 9, 20232 updates tracked since enumeration
NPPES CertifiedMay 9, 2023
✔ NPI 1255984837 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 TX · AP142103
6440 RENDON BLOODWORTH RD, Fort Worth, TX 76140
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mrs. Kelli Ann Vickrey Fnp-c has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 6, 2020 through April 6, 2028.

Opt-Out Effective DateApril 6, 2020
Opt-Out In Effect ThroughApril 6, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76140 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
$87.20 typical visit price
range $56.47 – $171.07
Typical copayment $21.80 (range $14.11 – $42.76)
Most-billed visit code 99203
Established Patient
$99.68 typical visit price
range $18.18 – $139.68
Typical copayment $24.92 (range $4.54 – $34.92)
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.

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 Kelli Vickrey's NPI number?

The NPI number for Kelli Vickrey is 1255984837. It was assigned to this individual provider in the NPPES registry on July 22, 2019.

Where is Kelli Vickrey located?

Kelli Vickrey practices at 6440 Rendon Bloodworth Rd, Fort Worth, TX 76140. The listed phone number is (817) 662-2550.

What is Kelli Vickrey's specialty?

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

Is Kelli Vickrey enrolled in Medicare?

No. Kelli Vickrey has opted out of Medicare through April 6, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Kelli Vickrey was last updated on May 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.