Kenzie Gardner, NP in Clarkston, MI - Medicare Nurse Practitioner

Kenzie Gardner, NP is a medicare enrolled "Nurse Practitioner - Family" in Clarkston, Michigan. Her current practice location is 7643 Olde Sturbridge Trl, Clarkston, Michigan. You can reach out to her office (for appointments etc.) via phone at (614) 507-3765.

Kenzie Gardner is licensed to practice in Michigan (license number 4704335952) 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 1720596802.

Contact Information

	Kenzie Gardner, NP
	7643 Olde Sturbridge Trl, Clarkston, MI 48348-4613
	(614) 507-3765
	Not Available

Map and Direction

Provider's Profile

Full Name	Kenzie Gardner
Gender	Female
Speciality	Nurse Practitioner - Family
Location	7643 Olde Sturbridge Trl, Clarkston, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1720596802
Provider Enumeration Date: 01/11/2018
Last Update Date: 07/12/2019

Medicare PECOS Information:

PECOS PAC ID: 8628325941
Enrollment ID: I20180718001310

Medical Identifiers

Medical identifiers for Kenzie Gardner such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1720596802	NPI	-	NPPES
4704335952	Other	MI	NP LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	4704335952 (Michigan)	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. Kenzie Gardner allows following entities to bill medicare on her behalf.

Entity Name	Jennifer Caudill, Md Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1477841245 PECOS PAC ID: 6305017625 Enrollment ID: O20110919000187

Entity Name	Main Street Dermatology Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1881371946 PECOS PAC ID: 3476917766 Enrollment ID: O20230920000987

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. Kenzie Gardner 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
Kenzie Gardner, NP 7643 Olde Sturbridge Trl, Clarkston, MI 48348-4613 Ph: () -	Kenzie Gardner, NP 7643 Olde Sturbridge Trl, Clarkston, MI 48348-4613 Ph: (614) 507-3765

Reviews and Comments

Nurse Practitioner Nurses in Clarkston, MI

Mrs. Susan Louise Clark, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5701 Bow Pointe Dr, Suite 225, Clarkston, MI 48346 Phone: 248-384-8300 Fax: 248-384-8309
Bradley David Winter, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 6549 Town Center Dr Ste A, Clarkston, MI 48346 Phone: 800-395-3223
Kimberly Marie Visintine, DNP, APRN, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6315 Crab Apple St, Clarkston, MI 48346 Phone: 248-207-0206
Gabrielle Domenica Fazio, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5701 Bow Pointe Dr Ste 120, Clarkston, MI 48346 Phone: 248-922-6880
Suzanne Marie Lugger, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5028 Ridge Trl S, Clarkston, MI 48348 Phone: 248-568-7189
Cindy Kay Fulton, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 7013 Oakhurst Ridge Rd, Clarkston, MI 48348 Phone: 989-670-9510
Daniel Joseph Dean, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 7300 Dixie Hwy Ste 1000, Clarkston, MI 48346 Phone: 517-882-3732 Fax: 517-882-3633

Kenzie Gardner, NP - Medicare Nurse Practitioner in Clarkston, MI