Mrs Kelley Nicole Larson, LSW in Rockford, IL - Medicare Social Worker Provider

Mrs Kelley Nicole Larson, LSW is a medicare enrolled "Social Worker - Clinical" provider in Rockford, Illinois. Her current practice location is 301 E State St, Rockford, Illinois. You can reach out to her office (for appointments etc.) via phone at (815) 668-7810.

Mrs Kelley Nicole Larson is licensed to practice in Illinois (license number 149.026923) 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 1023764263.

Contact Information

	Mrs Kelley Nicole Larson, LSW
	301 E State St, Rockford, IL 61104-1012
	(815) 668-7810
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Kelley Nicole Larson
Gender	Female
Speciality	Social Worker - Clinical
Location	301 E State St, Rockford, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1023764263
Provider Enumeration Date: 02/25/2022
Last Update Date: 04/23/2024

Medicare PECOS Information:

PECOS PAC ID: 3971045162
Enrollment ID: I20240603003354

Medical Identifiers

Medical identifiers for Mrs Kelley Nicole Larson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1023764263	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	149.026923 (Illinois)	Primary
104100000X	Social Worker	150105997 (Illinois)	Secondary

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 Kelley Nicole Larson allows following entities to bill medicare on her behalf.

Entity Name	Oak Street Health Physicians Group Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1083051643 PECOS PAC ID: 7517109879 Enrollment ID: O20130815000670

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 Kelley Nicole Larson 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 Kelley Nicole Larson, LSW 1021 N Mulford Rd, Rockford, IL 61107-3874 Ph: () -	Mrs Kelley Nicole Larson, LSW 301 E State St, Rockford, IL 61104-1012 Ph: (815) 668-7810

Reviews and Comments

Social Worker in Rockford, IL

Kelly Finch, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 4320 Spring Creek Rd, Ste 19, Rockford, IL 61107 Phone: 815-222-9485
Mrs. Jessica M Gregg, MSW LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5758 Elaine Dr Ste 101c, Rockford, IL 61108 Phone: 815-975-1177
Miss Marcy L Turek, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1601 Parkview Ave, University Psychiatric Services, Rockford, IL 61107 Phone: 815-395-5874 Fax: 815-395-5644
Stephanie A Johnson, LCSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 4835 Manhattan Dr Ste 4, Rockford, IL 61108 Phone: 815-520-2303
Dana Stephen Kiley, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 2823 Glenwood Ave, Rockford, IL 61101 Phone: 815-968-5342 Fax: 815-968-4656
Paula Tripodi, L.C.S.W. Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 6735 Vistagreen Way Ste 210, Rockford, IL 61107 Phone: 815-742-7489 Fax: 815-904-6419

Mrs Kelley Nicole Larson, LSW - Medicare Clinical Social Worker in Rockford, IL