Kimber Marie Sanderson, APRN is a medicare enrolled "Nurse Practitioner - Family" in Weleetka, Oklahoma. Her current practice location is
315 W 9th St, Weleetka, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(405) 786-2248.
Kimber Marie Sanderson is licensed to practice in Oklahoma (license number R0111358) 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 1710519004.
Provider's Profile
| Full Name | Kimber Marie Sanderson |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 315 W 9th St, Weleetka, Oklahoma |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1710519004
- Provider Enumeration Date: 02/05/2020
- Last Update Date: 12/12/2023
Medicare PECOS Information:
- PECOS PAC ID: 6204202880
- Enrollment ID: I20221024000368
Medical Identifiers
Medical identifiers for Kimber Marie Sanderson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1710519004 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 163WG0600X | Registered Nurse - Gerontology | R0111358 (Oklahoma) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | R0111358 (Oklahoma) | 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. Kimber Marie Sanderson allows following entities to bill medicare on her behalf.
| Entity Name | Integrated Care Professionals Of Oklahoma, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1245842848
PECOS PAC ID: 1759700933
Enrollment ID: O20210203002330 |
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| Entity Name | Icp Oklahoma Aco Billing Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1255915427
PECOS PAC ID: 0244639284
Enrollment ID: O20210525001775 |
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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. Kimber Marie Sanderson 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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Kimber Marie Sanderson, APRN
15501 Mulberry Rd,
Henryetta, OK 74437-8112
Ph: (405) 584-1071 | Kimber Marie Sanderson, APRN
315 W 9th St,
Weleetka, OK 74880-8117
Ph: (405) 786-2248 |
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