Kelly Dean Shrum, DO is a medicare enrolled "Obstetrics & Gynecology" physician in Monticello, Arkansas. He went to Oklahoma State University College Of Osteopathic Medicine and graduated in 1994 and has 30 years of diverse experience with area of expertise as Obstetrics/gynecology. He is a member of the group practice Mainline Health Systems, Inc and his current practice location is
535 Jordan Dr, Monticello, Arkansas. You can reach out to his office (for appointments etc.) via phone at
(870) 367-6246.
Kelly Dean Shrum is licensed to practice in Arkansas (license number E0704) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1427028638.
Physician's Profile
| Full Name | Kelly Dean Shrum |
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| Gender | Male |
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| Speciality | Obstetrics/gynecology |
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| Experience | 30 Years |
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| Location | 535 Jordan Dr, Monticello, Arkansas |
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| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Kelly Dean Shrum attended and graduated from Oklahoma State University College Of Osteopathic Medicine in 1994
NPI Data:
- NPI Number: 1427028638
- Provider Enumeration Date: 01/23/2006
- Last Update Date: 08/18/2022
Medicare PECOS Information:
- PECOS PAC ID: 3577606052
- Enrollment ID: I20100205000277
Medical Identifiers
Medical identifiers for Kelly Dean Shrum such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1427028638 | NPI | - | NPPES |
| 18424000000 | Other | AR | QUALCHOICE |
| 136791003 | Medicaid | AR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207V00000X | Obstetrics & Gynecology | E0704 (Arkansas) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Mainline Health Systems, Inc | 5193785590 | 47 |
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 Dean Shrum allows following entities to bill medicare on his behalf.
| Entity Name | Mainline Health Systems, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1922727726
PECOS PAC ID: 5193785590
Enrollment ID: O20041011000567 |
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| Entity Name | Drew Professional Services, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1841548427
PECOS PAC ID: 7214187640
Enrollment ID: O20121022000130 |
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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 Dean Shrum 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 Dean Shrum, DO
Po Box 509,
Dermott, AR 71638-0509
Ph: (870) 538-5414 | Kelly Dean Shrum, DO
535 Jordan Dr,
Monticello, AR 71655-5714
Ph: (870) 367-6246 |
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