Kristi Ann Weaver, in Carbondale, IL - Medicare Counselor Provider

Kristi Ann Weaver, is a medicare enrolled "Counselor - Mental Health" provider in Carbondale, Illinois. Her current practice location is 2311 S Illinois Ave, Carbondale, Illinois. You can reach out to her office (for appointments etc.) via phone at (618) 457-6703.

Kristi Ann Weaver is licensed to practice in Illinois (license number 180.009792) 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 1053669903.

Contact Information

	Kristi Ann Weaver,
	2311 S Illinois Ave, Carbondale, IL 62903-5912
	(618) 457-6703
	(618) 549-3734

Map and Direction

Healthcare Provider's Profile

Full Name	Kristi Ann Weaver
Gender	Female
Speciality	Counselor - Mental Health
Location	2311 S Illinois Ave, Carbondale, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1053669903
Provider Enumeration Date: 08/27/2012
Last Update Date: 04/16/2024

Medicare PECOS Information:

PECOS PAC ID: 4688016025
Enrollment ID: I20240530001751

Medical Identifiers

Medical identifiers for Kristi Ann Weaver such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1053669903	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	180009792 (Illinois)	Secondary
101YM0800X	Counselor - Mental Health	180.009792 (Illinois)	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. Kristi Ann Weaver allows following entities to bill medicare on her behalf.

Entity Name	Brave Health Medical Group, P.a
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1225669161 PECOS PAC ID: 9537586052 Enrollment ID: O20210129001373

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. Kristi Ann Weaver 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
Kristi Ann Weaver, 1190 Grand Oak Dr, Carbondale, IL 62901-5474 Ph: (618) 534-0607	Kristi Ann Weaver, 2311 S Illinois Ave, Carbondale, IL 62903-5912 Ph: (618) 457-6703

Reviews and Comments

Counselor in Carbondale, IL

Mr. Dave Scott Evans, MS, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 604 East College, Carbondale, IL 62901 Phone: 618-457-6703 Fax: 618-529-4563
Emily Margaret Macdonald, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2311 S Illinois Ave, Carbondale, IL 62903 Phone: 629-278-2696
Ms. Melissa Cauthen, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1016 S Emerald Ln, Carbondale, IL 62901 Phone: 618-559-6346
Poorva Talapatra, M.ED., LCPC Counselor Medicare: Medicare Enrolled Practice Location: 400 S Lewis Ln, Carbondale, IL 62901 Phone: 618-519-9900 Fax: 618-529-1384
Levi Wampler, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2311 S Illinois Ave, Carbondale, IL 62903 Phone: 618-615-9754
Anna Hughes, MSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 2311 S Illinois Ave, Carbondale, IL 62903 Phone: 618-457-6703 Fax: 618-549-3734
Lindsay Miller, LCPC Counselor Medicare: Medicare Enrolled Practice Location: 101 S Wall St, Carbondale, IL 62901 Phone: 618-519-9200 Fax: 618-519-9404

Kristi Ann Weaver, - Medicare Counselor in Carbondale, IL