Kelly Marie Summers, ARNP is a medicare enrolled "Nurse Practitioner" physician in Jacksonville, Florida. Her current practice location is
807 Childrens Way, Jacksonville, Florida. You can reach out to her office (for appointments etc.) via phone at
(904) 697-3600.
Kelly Marie Summers is licensed to practice in Florida (license number ARNP9311879) 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 1023531043.
Physician's Profile
| Full Name | Kelly Marie Summers |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 807 Childrens Way, Jacksonville, Florida |
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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: 1023531043
- Provider Enumeration Date: 07/21/2017
- Last Update Date: 10/13/2017
Medicare PECOS Information:
- PECOS PAC ID: 8123392388
- Enrollment ID: I20170927000304
Medical Identifiers
Medical identifiers for Kelly Marie Summers such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1023531043 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2080P0206X | Pediatrics - Pediatric Gastroenterology | ARNP9311879 (Florida) | Secondary |
| 363L00000X | Nurse Practitioner | ARNP9311879 (Florida) | 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 Marie Summers allows following entities to bill medicare on her behalf.
| Entity Name | The Nemours Foundation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1386658615
PECOS PAC ID: 9537072483
Enrollment ID: O20040109000252 |
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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 Marie Summers 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 Marie Summers, ARNP
10140 Centurion Pkwy N,
Jacksonville, FL 32256-0532
Ph: () - | Kelly Marie Summers, ARNP
807 Childrens Way,
Jacksonville, FL 32207-8426
Ph: (904) 697-3600 |
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