Nicole Renea Nethery, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Ellettsville, Indiana. Her current practice location is
6691 W Legacy Ln, Ellettsville, Indiana. You can reach out to her office (for appointments etc.) via phone at
(812) 272-0591.
Nicole Renea Nethery is licensed to practice in Indiana (license number 34008563A) 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 1063166684.
Healthcare Provider's Profile
Full Name | Nicole Renea Nethery |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 6691 W Legacy Ln, Ellettsville, Indiana |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1063166684
- Provider Enumeration Date: 02/11/2022
- Last Update Date: 02/11/2022
Medicare PECOS Information:
- PECOS PAC ID: 9234594367
- Enrollment ID: I20230425002015
Medical Identifiers
Medical identifiers for Nicole Renea Nethery such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1063166684 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | 34008563A (Indiana) | 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. Nicole Renea Nethery allows following entities to bill medicare on her behalf.
Entity Name | Onhealthcare Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1417220369 PECOS PAC ID: 8527221480 Enrollment ID: O20120514000325 |
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Entity Name | Grow Healthcare Group Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220510002320 |
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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. Nicole Renea Nethery 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 |
Nicole Renea Nethery, LCSW 6691 W Legacy Ln, Ellettsville, IN 47429-9267 Ph: (812) 272-0591 | Nicole Renea Nethery, LCSW 6691 W Legacy Ln, Ellettsville, IN 47429-9267 Ph: (812) 272-0591 |
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