KELLY DAVIS ANDERSON FNP
NPI 1730195330
Nurse Practitioner - Family in Portland, OR
About Kelly Davis Anderson Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY DAVIS ANDERSON FNP (NPI 1730195330) is an individual family provider in Portland, Oregon, licensed in Oregon (099007722N1) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kelly Davis Anderson Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kelly Anderson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Portland, OR 97239
- Reassigned Medicare billing, Oregon enrollment
- 2,212 clinicians in this Medicare group
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 97239 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
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 1730195330. It was assigned to this individual provider in the NPPES registry on August 1, 2006.
Where is Kelly Anderson located?
Kelly Anderson practices at 3181 SW Sam Jackson Park Rd, Portland, OR 97239. The listed phone number is (503) 418-5150.
What is Kelly Anderson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Kelly Anderson enrolled in Medicare?
Yes. Kelly Anderson is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kelly Anderson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Anderson reassigns Medicare benefits to University Professional Services (Portland, OR). The 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 Moda Health Plan, Inc., PacificSource Health Plans and Providence Health Plan 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 August 14, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Kelly Davis Anderson, FNP · NPI 1730195330
Family physician in Portland, Oregon. Individual provider, active in the CMS NPPES registry since August 1, 2006.
## Identity
- **NPI:** 1730195330 (Entity type: Individual)
- **Enumerated:** August 1, 2006
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 099007722N1 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 3181 SW SAM JACKSON PARK RD, Portland, OR 97239-3011
- **Phone:** (503) 418-5150
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** University Professional Services (NPI 1376709535, Portland, OR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 14, 2007
- **Other identifiers:** Medicare UPIN P24036; Medicaid 022565 (OR)
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Source: [NPI Profile](https://npiprofile.com/npi/1730195330) · Data from the CMS NPPES public registry.