Erica Kellyn Smith, PA-C, ATC is a medicare enrolled "Physician Assistant" physician in Vicksburg, Mississippi. Her current practice location is
2100 Highway 61 N, Vicksburg, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(601) 883-5000.
Erica Kellyn Smith is licensed to practice in Mississippi (license number PA00777) 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 1477013456.
Physician's Profile
| Full Name | Erica Kellyn Smith |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Location | 2100 Highway 61 N, Vicksburg, Mississippi |
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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: 1477013456
- Provider Enumeration Date: 03/25/2019
- Last Update Date: 02/20/2024
Medicare PECOS Information:
- PECOS PAC ID: 4981041985
- Enrollment ID: I20240326003981
Medical Identifiers
Medical identifiers for Erica Kellyn Smith such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1477013456 | NPI | - | NPPES |
| NA | Other | | NA |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207X00000X | Orthopaedic Surgery | PA00777 (Mississippi) | Secondary |
| 363A00000X | Physician Assistant | PA00777 (Mississippi) | 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. Erica Kellyn Smith 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 |
|---|
Erica Kellyn Smith, PA-C, ATC
4 Glenwood Cir,
Vicksburg, MS 39180-3942
Ph: (601) 540-4936 | Erica Kellyn Smith, PA-C, ATC
2100 Highway 61 N,
Vicksburg, MS 39183-8211
Ph: (601) 883-5000 |
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