Kalisa Mickell, FNP in Tupelo, MS - Medicare Nurse Practitioner

Kalisa Mickell, FNP is a medicare enrolled "Nurse Practitioner - Family" in Tupelo, Mississippi. She graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice North Mississippi Medical Center Inc and her current practice location is 830 S Gloster St, Tupelo, Mississippi. You can reach out to her office (for appointments etc.) via phone at (662) 377-3000.

Kalisa Mickell is licensed to practice in Mississippi (license number 904311) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1013504067.

Contact Information

	Kalisa Mickell, FNP
	830 S Gloster St, Tupelo, MS 38801-4934
	(662) 377-3000
	Not Available

Map and Direction

Provider's Profile

Full Name	Kalisa Mickell
Gender	Female
Speciality	Nurse Practitioner
Experience	4 Years
Location	830 S Gloster St, Tupelo, Mississippi
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Kalisa Mickell graduated from nursing school in 2020

NPI Data:

NPI Number: 1013504067
Provider Enumeration Date: 12/23/2020
Last Update Date: 04/07/2021

Medicare PECOS Information:

PECOS PAC ID: 7719370402
Enrollment ID: I20220201001225

Medical Identifiers

Medical identifiers for Kalisa Mickell such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1013504067	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	904311 (Mississippi)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
North Mississippi Medical Center	Tupelo, MS	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
North Mississippi Medical Center Inc	9931010600	285

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. Kalisa Mickell allows following entities to bill medicare on her behalf.

Entity Name	North Mississippi Medical Clinics Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1053469486 PECOS PAC ID: 6103736665 Enrollment ID: O20040127000582

Entity Name	North Mississippi Medical Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1972608347 PECOS PAC ID: 9931010600 Enrollment ID: O20040413000541

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. Kalisa Mickell 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
Kalisa Mickell, FNP 830 S Gloster St, Tupelo, MS 38801-4934 Ph: (662) 377-3000	Kalisa Mickell, FNP 830 S Gloster St, Tupelo, MS 38801-4934 Ph: (662) 377-3000

Reviews and Comments

Nurse Practitioner Nurses in Tupelo, MS

Nicole Sherice Taylor, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 845 South Gloster Street, Tupelo, MS 38801 Phone: 662-377-5930
Mrs. Rebecca Perry Ward, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4381 South Eason Blvd, Longtown Medical Park, Tupelo, MS 38801 Phone: 662-377-7354 Fax: 662-377-5301
Ms. Wanda Ikeda, ACNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 499 Gloster Creek Vlg Ste A2, Tupelo, MS 38801 Phone: 662-620-6800 Fax: 662-377-2403
Mrs. Tina King, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1573 Medical Park Cir, Tupelo, MS 38801 Phone: 662-844-9885 Fax: 662-842-1350
Anna Danielle Woodruff, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 499 Gloster Creek Vlg Ste H3, Tupelo, MS 38801 Phone: 662-840-6026 Fax: 662-840-6030
Jennifer L Taylor, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 830 S Gloster St, Tupelo, MS 38801 Phone: 205-412-0585

Kalisa Mickell, FNP - Medicare Nurse Practitioner in Tupelo, MS