MISS KELLY MARIE ANDERSON APRN, PMHNP-BC
NPI 1396251054
Nurse Practitioner - Psychiatric/Mental Health in Jacksonville, FL

Q: What is Kelly Anderson's NPI number?

The NPI number for Kelly Anderson is 1396251054. It was assigned to this individual provider in the NPPES registry on December 18, 2017.

Q: What is Kelly Anderson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kelly Anderson was last updated on November 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 December 18, 2017PECOS EnrolledAccepts Medicare Assignment

4500 SALISBURY RD STE 420, JACKSONVILLE, FL 32216(904) 800-6116(904) 337-4724 Get Directions Write a Review

NPPES record last updated: November 13, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 13, 2023, Nov 6, 2023, Jul 24, 2021 and 1 more (4 updates tracked since 2017).

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About Miss Kelly Marie Anderson Aprn, Pmhnp-bc NPPES

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

MISS KELLY MARIE ANDERSON APRN, PMHNP-BC (NPI 1396251054) is an individual psychiatric/mental health provider in Jacksonville, Florida, licensed in Florida (APRN11014261) and active in the NPI registry since December 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1396251054

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameMISS KELLY MARIE ANDERSONCredential: APRN, PMHNP-BC

Location Address4500 SALISBURY RD STE 420Jacksonville, FL 32216-0959

Mailing Address7014 San Jose BlvdJacksonville, FL 32217-3422 · (904) 904-0690

Phone(904) 800-6116

Fax(904) 337-4724

Sole ProprietorYes

Medical School CMSOtherGraduated 2021

Enumeration DateDecember 18, 2017

Last NPPES UpdateNovember 13, 20234 updates tracked since enumeration

NPPES CertifiedNovember 8, 2023

✔ NPI 1396251054 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 FL · APRN11014261

4500 SALISBURY RD STE 420, Jacksonville, FL 32216

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, Cigna HealthCare of Florida, Inc., Florida Blue (BlueCross BlueShield FL) and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Miss Kelly Marie Anderson Aprn, Pmhnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID648674002

PECOS Enrollment IDI20210806000826

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 Reassignments

Medicare enrollment records show Kelly Anderson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Balanced Wellbeing LLC

83 mi

Psychiatry

3200 SW 34TH AVE STE 701
Ocala, FL 34474

Reassigned Medicare billing, Florida enrollment
369 clinicians in this Medicare group

NPI 1336513639 (352) 445-1200

Mcr Health, Inc.

191 mi

Federally Qualified Health Center (FQHC)

12271 US HIGHWAY 301 N
Parrish, FL 34219

Reassigned Medicare billing, Florida enrollment
709 clinicians in this Medicare group

NPI 1255376000 (941) 776-4050

Grow Healthcare Group PA

320 mi

Mental Health

66 W FLAGLER ST STE 900
Miami, FL 33130

Reassigned Medicare billing, Florida enrollment
3,079 clinicians in this Medicare group

NPI 1245845932 (786) 244-7711

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 32216 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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

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

DR. LUBNA MORALES-ATALLAH PSYD

Clinical Neuropsychologist

4500 SALISBURY RD STE 420
JACKSONVILLE, FL 32216

Duval County (904) 800-6116

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 Kelly Anderson's NPI number?

The NPI number for Kelly Anderson is 1396251054. It was assigned to this individual provider in the NPPES registry on December 18, 2017.

Where is Kelly Anderson located?

Kelly Anderson practices at 4500 Salisbury Rd Ste 420, Jacksonville, FL 32216. The listed phone number is (904) 800-6116.

What is Kelly Anderson's specialty?

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

Is Kelly Anderson enrolled in Medicare?

Yes. Kelly Anderson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kelly Anderson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Anderson reassigns Medicare benefits to 3 organizations: Balanced Wellbeing LLC (Ocala, FL), Mcr Health, Inc. (Parrish, FL) and Grow Healthcare Group PA (Miami, FL). Each 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 Kelly Anderson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelly Anderson accept?

Health plans from Cigna HealthCare of Florida, Inc., Cigna Healthcare, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Oscar Health Maintenance Organization of Florida and 1 other insurer list Kelly Anderson 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 Kelly Anderson was last updated on November 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.