Mrs Kellie Fleming Smith, MAUD, CCC-A is a medicare enrolled "Audiologist" provider in Moultrie, Georgia. Her current practice location is
3 Hospital Park, Moultrie, Georgia. You can reach out to her office (for appointments etc.) via phone at
(229) 891-9131.
Mrs Kellie Fleming Smith is licensed to practice in Georgia (license number AUD003314) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1306996103.
Healthcare Provider's Profile
| Full Name | Mrs Kellie Fleming Smith |
|---|
| Gender | Female |
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| Speciality | Audiologist |
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| Location | 3 Hospital Park, Moultrie, Georgia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1306996103
- Provider Enumeration Date: 01/12/2007
- Last Update Date: 07/28/2023
Medicare PECOS Information:
- PECOS PAC ID: 2769677780
- Enrollment ID: I20101116000304
Medical Identifiers
Medical identifiers for Mrs Kellie Fleming Smith such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1306996103 | NPI | - | NPPES |
| 000969262D | Medicaid | GA | |
| 000969262E | Medicaid | GA | |
| 000969262C | Medicaid | GA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 231H00000X | Audiologist | AUD003314 (Georgia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Kellie Fleming Smith allows following entities to bill medicare on her behalf.
| Provider Name | Colquitt Regional Ear Nose & Throat |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1477939833
PECOS PAC ID: 2264741941
Enrollment ID: O20151020001372 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Kellie Fleming Smith is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mrs Kellie Fleming Smith, MAUD, CCC-A
Po Box 2876,
Moultrie, GA 31776-2876
Ph: (229) 891-9131 | Mrs Kellie Fleming Smith, MAUD, CCC-A
3 Hospital Park,
Moultrie, GA 31768-6772
Ph: (229) 891-9131 |
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