Miss Kelly Marie Anderson, APRN, PMHNP-BC - Medicare Nurse Practitioner in Jacksonville, FL

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Miss Kelly Marie Anderson, APRN, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Jacksonville, Florida. Her current practice location is 4500 Salisbury Rd Ste 420, Jacksonville, Florida. You can reach out to her office (for appointments etc.) via phone at (904) 800-6116.

Miss Kelly Marie Anderson is licensed to practice in Florida (license number APRN11014261) 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 1396251054.

Contact Information

Miss Kelly Marie Anderson, APRN, PMHNP-BC
4500 Salisbury Rd Ste 420,
Jacksonville, FL 32216-0959
(904) 800-6116
(904) 337-4724

Map and Direction




Provider's Profile

Full NameMiss Kelly Marie Anderson
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location4500 Salisbury Rd Ste 420, Jacksonville, Florida
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1396251054
  • Provider Enumeration Date: 12/18/2017
  • Last Update Date: 11/13/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 0648674002
  • Enrollment ID: I20210806000826

Medical Identifiers

Medical identifiers for Miss Kelly Marie Anderson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1396251054NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health APRN11014261 (Florida)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. Miss Kelly Marie Anderson allows following entities to bill medicare on her behalf.
Entity NameMcr Health Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1255376000
PECOS PAC ID: 7214847995
Enrollment ID: O20040126000213
Entity NameBalanced Wellbeing Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1336513639
PECOS PAC ID: 5193021848
Enrollment ID: O20160307002587
Entity NameGrow Healthcare Group Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1245845932
PECOS PAC ID: 3476961368
Enrollment ID: O20210414000053

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. Miss Kelly Marie Anderson 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 AddressPractice Location Address
Miss Kelly Marie Anderson, APRN, PMHNP-BC
7014 San Jose Blvd,
Jacksonville, FL 32217-3422

Ph: (904) 904-0690		Miss Kelly Marie Anderson, APRN, PMHNP-BC
4500 Salisbury Rd Ste 420,
Jacksonville, FL 32216-0959

Ph: (904) 800-6116

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.