Kelly Manner, RD is a medicare enrolled "Dietitian, Registered" provider in Grand Rapids, Minnesota. Her current practice location is
1601 Golf Course Rd, Grand Rapids, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(218) 999-1671.
Kelly Manner is licensed to practice in Minnesota (license number 958365) 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 1710511282.
Healthcare Provider's Profile
| Full Name | Kelly Manner |
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| Gender | Female |
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| Speciality | Dietitian, Registered |
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| Location | 1601 Golf Course Rd, Grand Rapids, Minnesota |
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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: 1710511282
- Provider Enumeration Date: 02/24/2020
- Last Update Date: 02/24/2020
Medicare PECOS Information:
- PECOS PAC ID: 8921458274
- Enrollment ID: I20231228001864
Medical Identifiers
Medical identifiers for Kelly Manner such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1710511282 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | 958365 (Minnesota) | 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 Manner allows following entities to bill medicare on her behalf.
| Provider Name | Grand Itasca Clinic And Hospital |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1669426631
PECOS PAC ID: 8123939550
Enrollment ID: O20031105000209 |
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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 Manner 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 Manner, RD
3868 Maple Hill Rd,
Hibbing, MN 55746-8340
Ph: () - | Kelly Manner, RD
1601 Golf Course Rd,
Grand Rapids, MN 55744-8648
Ph: (218) 999-1671 |
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