MS. MARYALICE KELLY APN
NPI 1326071283
Nurse Practitioner in Fayetteville, AR

Q: What is Maryalice Kelly's NPI number?

The NPI number for Maryalice Kelly is 1326071283. It was assigned to this individual provider in the NPPES registry on July 7, 2006.

Q: What is Maryalice Kelly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Maryalice Kelly was last updated on April 7, 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.

Active since July 07, 2006PECOS Enrolled

1125 N COLLEGE AVE, FAYETTEVILLE, AR 72703(479) 713-8000(479) 443-3903 Get Directions Write a Review

NPPES record last updated: April 7, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Ms. Maryalice Kelly Apn NPPES

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

MS. MARYALICE KELLY APN (NPI 1326071283) is an individual nurse practitioner in Fayetteville, Arkansas, licensed in Arkansas (A001933) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1326071283

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMS. MARYALICE KELLYCredential: APN

Location Address1125 N COLLEGE AVEFayetteville, AR 72703-1908

Mailing AddressPo Box 251420Little Rock, AR 72225-1420 · (501) 686-8000 · Fax (501) 526-5148

Phone(479) 713-8000

Fax(479) 443-3903

Sole ProprietorNo

Enumeration DateJuly 7, 2006

Last NPPES UpdateApril 7, 2023

NPPES CertifiedApril 7, 2023

✔ NPI 1326071283 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in AR · A001933

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

1125 N COLLEGE AVE, Fayetteville, AR 72703

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Other Identifiers 1

Medicaid182728758AR

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Maryalice Kelly Apn 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 72703 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

$79.72 typical visit price

range $51.36 – $157.74

Typical copayment $19.93 (range $12.84 – $39.43)

Most-billed visit code 99203

Established Patient

$91.63 typical visit price

range $16.16 – $128.77

Typical copayment $22.90 (range $4.04 – $32.19)

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.

GRACE WOOD

Student in an Organized Health Care Education/Training Program