1. Home
  2. Directory
  3. Arkansas
  4. Fayetteville
  5. Nurse Practitioner
  6. NPI Profile

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

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: July 26, 2026.

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 and maintains a secondary practice location in Springdale.

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
Open in Google Maps ↗

Secondary Practice Location 1

Location 12422 N Thompson StSpringdale, AR 72764-1757 · Phone (479) 750-6566 · Fax (479) 750-5251

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
1125 N COLLEGE AVE
FAYETTEVILLE, AR 72703
Washington County (479) 713-8000
COLIN CARR MD
Student in an Organized Health Care Education/Training Program
1125 N COLLEGE AVE
FAYETTEVILLE, AR 72703
Washington County (479) 463-3370
JENNIFER STEINAUER PTA
Physical Therapy Assistant
1125 N COLLEGE AVE
FAYETTEVILLE, AR 72703
Washington County (479) 713-8630
RYAN RUSSELL
Student in an Organized Health Care Education/Training Program
1125 N COLLEGE AVE
FAYETTEVILLE, AR 72703
Washington County (479) 521-8260
KELVIN VANN
Student in an Organized Health Care Education/Training Program
1125 N COLLEGE AVE
FAYETTEVILLE, AR 72703
Washington County (479) 521-8260
LUKE TOLLETT MD
Student in an Organized Health Care Education/Training Program
1125 N COLLEGE AVE
FAYETTEVILLE, AR 72703
Washington County (479) 521-8260
DR. TONY SCOTT ROLLER II MD
Student in an Organized Health Care Education/Training Program
1125 N COLLEGE AVE
FAYETTEVILLE, AR 72703
Washington County (479) 521-8260
DR. JAMILA WEATHERLY MD
Student in an Organized Health Care Education/Training Program
1125 N COLLEGE AVE
FAYETTEVILLE, AR 72703
Washington County (479) 521-8260

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 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.

Where is Maryalice Kelly located?

Maryalice Kelly practices at 1125 N College Ave, Fayetteville, AR 72703. The listed phone number is (479) 713-8000.

What is Maryalice Kelly's specialty?

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

Is Maryalice Kelly enrolled in Medicare?

Yes. Maryalice Kelly is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Maryalice Kelly was last updated on April 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.