Keith Ray Fannin, RN in Lebanon, NH - Medicare Nurse Practitioner

Keith Ray Fannin, RN is a medicare enrolled "Nurse Practitioner - Family" in Lebanon, New Hampshire. His current practice location is One Medical Center Drive, Dartmouth Hitchcock - General Surgery, Lebanon, New Hampshire. You can reach out to his office (for appointments etc.) via phone at (603) 650-7903.

Keith Ray Fannin is licensed to practice in New Hampshire (license number 077205-23) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1457809881.

Contact Information

	Keith Ray Fannin, RN
	One Medical Center Drive, Dartmouth Hitchcock - General Surgery, Lebanon, NH 03756
	(603) 650-7903
	Not Available

Map and Direction

Provider's Profile

Full Name	Keith Ray Fannin
Gender	Male
Speciality	Nurse Practitioner - Family
Location	One Medical Center Drive, Lebanon, New Hampshire
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1457809881
Provider Enumeration Date: 09/14/2016
Last Update Date: 03/20/2018

Medicare PECOS Information:

PECOS PAC ID: 3971865718
Enrollment ID: I20180315000582

Medical Identifiers

Medical identifiers for Keith Ray Fannin such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1457809881	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163WC0200X	Registered Nurse - Critical Care Medicine	RN.372827 (Ohio)	Secondary
363L00000X	Nurse Practitioner	077205-23 (New Hampshire)	Secondary
363LF0000X	Nurse Practitioner - Family	077205-23 (New Hampshire)	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. Keith Ray Fannin allows following entities to bill medicare on his behalf.

Entity Name	Mary Hitchcock Memorial Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1023092053 PECOS PAC ID: 4486561164 Enrollment ID: O20031126000258

Entity Name	Valley Regional Hospital Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366687683 PECOS PAC ID: 5799683280 Enrollment ID: O20031222000429

Entity Name	Dartmouth-hitchcock Clinic
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1548210198 PECOS PAC ID: 4183537509 Enrollment ID: O20040809000442

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. Keith Ray Fannin 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
Keith Ray Fannin, RN One Medical Center Drive, Dartmouth Hitchcock - General Surgery, Lebanon, NH 03756 Ph: (603) 650-7903	Keith Ray Fannin, RN One Medical Center Drive, Dartmouth Hitchcock - General Surgery, Lebanon, NH 03756 Ph: (603) 650-7903

Reviews and Comments

Nurse Practitioner Nurses in Lebanon, NH

Mrs. Janice M Brennan, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1 Medical Center Dr, Dhmc Department Of Occupation Medicine, Lebanon, NH 03756 Phone: 603-560-5000 Fax: 603-650-0787
Meredith Anne Stringer, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1 Medical Center Dr, Lebanon, NH 03756 Phone: 603-650-5000
Carol Williams-suich, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5 Alice Peck Day Dr, Lebanon, NH 03766 Phone: 603-448-3122 Fax: 603-448-7491
Cassandra M Godzik, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: One Medical Center Dr, Lebanon, NH 03756 Phone: 603-650-7232
Deann Opal Mcnamara, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1 Medical Center Dr, Lebanon, NH 03756 Phone: 603-650-5922
Emily L Swann, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1 Medical Dr, Lebanon, NH 03756 Phone: 603-650-6224
Molly P Keady, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1 Medical Center Dr, Lebanon, NH 03756 Phone: 603-650-8622

Keith Ray Fannin, RN - Medicare Nurse Practitioner in Lebanon, NH