Alexis Nicole Chancellor, RD/LD is a medicare enrolled "Dietitian, Registered" provider in Jay, Oklahoma. Her current practice location is
859 E Melton Dr, Jay, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(918) 253-1744.
Alexis Nicole Chancellor is licensed to practice in Oklahoma (license number 2490) 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 1235762600.
Healthcare Provider's Profile
| Full Name | Alexis Nicole Chancellor |
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| Gender | Female |
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| Speciality | Dietitian, Registered |
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| Location | 859 E Melton Dr, Jay, Oklahoma |
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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: 1235762600
- Provider Enumeration Date: 02/13/2020
- Last Update Date: 09/19/2023
Medicare PECOS Information:
- PECOS PAC ID: 1557799418
- Enrollment ID: I20200309000680
Medical Identifiers
Medical identifiers for Alexis Nicole Chancellor such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1235762600 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | 2490 (Oklahoma) | 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. Alexis Nicole Chancellor allows following entities to bill medicare on her behalf.
| Provider Name | Cherokee Nation |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1780692723
PECOS PAC ID: 5799698742
Enrollment ID: O20031106000628 |
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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. Alexis Nicole Chancellor 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 |
|---|
Alexis Nicole Chancellor, RD/LD
Po Box 350,
Jay, OK 74346-0350
Ph: (918) 253-1744 | Alexis Nicole Chancellor, RD/LD
859 E Melton Dr,
Jay, OK 74346-2704
Ph: (918) 253-1744 |
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