Kelly Buckingham, is a medicare enrolled "Social Worker - Clinical" provider in Sheridan, Wyoming. Her current practice location is
1876 S Sheridan Ave, Sheridan, Wyoming. You can reach out to her office (for appointments etc.) via phone at
(307) 672-0475.
Kelly Buckingham is licensed to practice in Wyoming (license number 634) 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 1568786770.
Healthcare Provider's Profile
| Full Name | Kelly Buckingham |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 1876 S Sheridan Ave, Sheridan, Wyoming |
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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: 1568786770
- Provider Enumeration Date: 03/16/2010
- Last Update Date: 05/21/2021
Medicare PECOS Information:
- PECOS PAC ID: 4082006747
- Enrollment ID: I20230105003120
Medical Identifiers
Medical identifiers for Kelly Buckingham such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1568786770 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 340 (Wyoming) | Secondary |
| 1041C0700X | Social Worker - Clinical | 4975 (North Dakota) | Secondary |
| 1041C0700X | Social Worker - Clinical | 634 (Wyoming) | 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. Kelly Buckingham allows following entities to bill medicare on her behalf.
| Entity Name | Volunteers Of America Northern Rockies |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1689249682
PECOS PAC ID: 1355733015
Enrollment ID: O20220110002012 |
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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. Kelly Buckingham 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 |
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Kelly Buckingham,
1876 S Sheridan Ave,
Sheridan, WY 82801-6136
Ph: (307) 672-0475 | Kelly Buckingham,
1876 S Sheridan Ave,
Sheridan, WY 82801-6136
Ph: (307) 672-0475 |
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