Kelly A Spray, CNP is a medicare enrolled "Nurse Practitioner - Family" in Pequot Lakes, Minnesota. She graduated from nursing school in 2013 and has 11 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice St Josephs Medical Center and her current practice location is
4317 W Woodman St, Pequot Lakes, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(218) 568-4416.
Kelly A Spray is licensed to practice in Minnesota (license number R194132-0) 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 1487095915.
Provider's Profile
| Full Name | Kelly A Spray |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 11 Years |
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| Location | 4317 W Woodman St, Pequot Lakes, Minnesota |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Kelly A Spray graduated from nursing school in 2013
NPI Data:
- NPI Number: 1487095915
- Provider Enumeration Date: 07/12/2013
- Last Update Date: 01/15/2016
Medicare PECOS Information:
- PECOS PAC ID: 2264659036
- Enrollment ID: I20140819001507
Medical Identifiers
Medical identifiers for Kelly A Spray such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1487095915 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | R194132-0 (Minnesota) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| St Josephs Medical Center | 8224948443 | 214 |
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 A Spray allows following entities to bill medicare on her behalf.
| Entity Name | St Josephs Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1568415974
PECOS PAC ID: 8224948443
Enrollment ID: O20031119000468 |
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| Entity Name | Brainerd Medical Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1295801777
PECOS PAC ID: 0648270272
Enrollment ID: O20070105000140 |
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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 A Spray 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 A Spray, CNP
523 N 3rd St,
Brainerd, MN 56401-3054
Ph: (218) 829-2861 | Kelly A Spray, CNP
4317 W Woodman St,
Pequot Lakes, MN 56472-3473
Ph: (218) 568-4416 |
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