Brandy Lee Vines, is a medicare enrolled "Nurse Practitioner - Family" in Pea Ridge, Arkansas. Her current practice location is
2103 Slack St, Pea Ridge, Arkansas. You can reach out to her office (for appointments etc.) via phone at
(765) 479-1980.
Brandy Lee Vines is licensed to practice in Arkansas (license number 227730) 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 1306602701.
Provider's Profile
| Full Name | Brandy Lee Vines |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 2103 Slack St, Pea Ridge, Arkansas |
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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: 1306602701
- Provider Enumeration Date: 02/23/2024
- Last Update Date: 02/23/2024
Medicare PECOS Information:
- PECOS PAC ID: 5193161974
- Enrollment ID: I20240314004305
Medical Identifiers
Medical identifiers for Brandy Lee Vines such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1306602701 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 227730 (Arkansas) | 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. Brandy Lee Vines allows following entities to bill medicare on her behalf.
| Entity Name | Washington Regional Medical System |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1306801485
PECOS PAC ID: 8820995434
Enrollment ID: O20051208000082 |
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| Entity Name | Pea Ridge Urgent Care Clinic |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1558140749
PECOS PAC ID: 1456796986
Enrollment ID: O20240223003115 |
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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. Brandy Lee Vines 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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Brandy Lee Vines,
2103 Slack St,
Pea Ridge, AR 72751-4005
Ph: (479) 756-1980 | Brandy Lee Vines,
2103 Slack St,
Pea Ridge, AR 72751-4005
Ph: (765) 479-1980 |
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