Brandy Divine, FNP in Kirksville, MO - Medicare Nurse Practitioner

Brandy Divine, FNP is a medicare enrolled "Nurse Practitioner - Family" in Kirksville, Missouri. Her current practice location is 900 E Laharpe St, Kirksville, Missouri. You can reach out to her office (for appointments etc.) via phone at (660) 665-1962.

Brandy Divine is licensed to practice in Missouri (license number 2016037534) 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 1457803363.

Contact Information

	Brandy Divine, FNP
	900 E Laharpe St, Kirksville, MO 63501-4520
	(660) 665-1962
	Not Available

Map and Direction

Provider's Profile

Full Name	Brandy Divine
Gender	Female
Speciality	Nurse Practitioner - Family
Location	900 E Laharpe St, Kirksville, Missouri
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1457803363
Provider Enumeration Date: 10/26/2016
Last Update Date: 07/01/2024

Medicare PECOS Information:

PECOS PAC ID: 8527347772
Enrollment ID: I20161111000685

Medical Identifiers

Medical identifiers for Brandy Divine such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1457803363	NPI	-	NPPES
1457803363	Medicaid	MO

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	2016037534 (Missouri)	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 Divine allows following entities to bill medicare on her behalf.

Entity Name	Preferred Family Healthcare, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1649474206 PECOS PAC ID: 0244256246 Enrollment ID: O20051019000599

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 Divine 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
Brandy Divine, FNP 1601 Old South River Rd, Saint Charles, MO 63303-4120 Ph: (636) 224-1210	Brandy Divine, FNP 900 E Laharpe St, Kirksville, MO 63501-4520 Ph: (660) 665-1962

Reviews and Comments

Nurse Practitioner Nurses in Kirksville, MO

Brooke April Sprague, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1611 S Baltimore St, Kirksville, MO 63501 Phone: 660-665-7575 Fax: 660-665-7576
Rachel Catherine Selby, AGACNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 800 W Jefferson St, Kirksville, MO 63501 Phone: 660-956-4392
Whitney Jean Roller, MSN, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1611 S Baltimore St, Kirksville, MO 63501 Phone: 660-665-7575
Kathy Ayers, F.N.P. Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 800 W Jefferson St, Kirksville, MO 63501 Phone: 662-626-2235 Fax: 660-626-2090
Teresa Lyn Tucker, RN, WHNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 100 E Normal Ave, Kirksville, MO 63501 Phone: 660-785-4182
Cassie Marie Tilton, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1506 Crown Dr, Kirksville, MO 63501 Phone: 660-627-4493
April Winkler, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1611 S Baltimore St, Kirksville, MO 63501 Phone: 660-665-7575

Brandy Divine, FNP - Medicare Nurse Practitioner in Kirksville, MO