KELLY FLACK APNP
NPI 1720601297
Nurse Practitioner in Oshkosh, WI

Q: What is Kelly Flack's NPI number?

The NPI number for Kelly Flack is 1720601297. It was assigned to this individual provider in the NPPES registry on May 19, 2020.

Q: What is Kelly Flack'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 Kelly Flack was last updated on November 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 May 19, 2020PECOS EnrolledAccepts Medicare Assignment

855 N WESTHAVEN DR, OSHKOSH, WI 54904(920) 033-8700(920) 456-5901 Get Directions Write a Review

NPPES record last updated: November 18, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 18, 2021, Sep 15, 2021, Jan 29, 2021 and 2 more (5 updates tracked since 2020).

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About Kelly Flack Apnp NPPES

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

KELLY FLACK APNP (NPI 1720601297) is an individual nurse practitioner in Oshkosh, Wisconsin, licensed in Wisconsin (10176-33) and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS, is affiliated with Bellin Memorial Hospital, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1720601297

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameKELLY FLACKCredential: APNP

Location Address855 N WESTHAVEN DROshkosh, WI 54904-7668

Mailing Address855 N Westhaven DrOshkosh, WI 54904-7668 · (920) 033-8700 · Fax (920) 456-5901

Phone(920) 033-8700

Fax(920) 456-5901

Sole ProprietorYes

Medical School CMSOtherGraduated 2020

Enumeration DateMay 19, 2020

Last NPPES UpdateNovember 18, 20215 updates tracked since enumeration

NPPES CertifiedNovember 18, 2021

✔ NPI 1720601297 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in WI · 10176-33

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.

Also ListedRegistered NurseTaxonomy 163W00000X · License 177650-30 (WI)

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 10176-33 (WI)

855 N WESTHAVEN DR, Oshkosh, WI 54904

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Other Identifiers 3

Other10176-33WI · Wisconsin Apnp License

Medicaid100146891WI

Other177650-30WI · Wisconsin Rn License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Flack Apnp 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 ID3971917345

PECOS Enrollment IDI20210126000964

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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

14 services14 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Bellin Memorial Hospital

Acute Care Hospitals · Green Bay, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520049

Location744 S Webster AveGreen Bay, WI 54305 · Brown County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54904 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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.

JACQUELINE ANN OTS PENDING

Nurse Practitioner