Dr Jalisa Brianne Kelly, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Greenville, North Carolina. Her current practice location is
2100 Stantonsburg Rd, Greenville, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(252) 744-1406.
Dr Jalisa Brianne Kelly is licensed to practice in * (Not Available) (license number ) 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 1407590722.
Physician's Profile
Full Name | Dr Jalisa Brianne Kelly |
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Gender | Female |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 2100 Stantonsburg Rd, Greenville, North Carolina |
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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: 1407590722
- Provider Enumeration Date: 04/22/2022
- Last Update Date: 04/10/2024
Medicare PECOS Information:
- PECOS PAC ID: 5294114062
- Enrollment ID: I20220624001187
Medical Identifiers
Medical identifiers for Dr Jalisa Brianne Kelly such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1407590722 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2084P0800X | Psychiatry & Neurology - Psychiatry | RTL22-0864 (North Carolina) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
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. Dr Jalisa Brianne Kelly 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 |
Dr Jalisa Brianne Kelly, MD 2100 Stantonsburg Rd, Greenville, NC 27834-2818 Ph: (252) 744-1406 | Dr Jalisa Brianne Kelly, MD 2100 Stantonsburg Rd, Greenville, NC 27834-2818 Ph: (252) 744-1406 |
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