Mr Shawn Demian Kelly, APRN in Daytona Beach, FL

Mr Shawn Demian Kelly, APRN is a medicare enrolled "Nurse Practitioner - Family" in Daytona Beach, Florida. His current practice location is 1667 N Clyde Morris Blvd Ste 2, Daytona Beach, Florida. You can reach out to his office (for appointments etc.) via phone at (386) 274-1414.

Mr Shawn Demian Kelly is licensed to practice in Florida (license number APRN9431397) 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 1174831093.

Contact Information

	Mr Shawn Demian Kelly, APRN
	1667 N Clyde Morris Blvd Ste 2, Daytona Beach, FL 32117-5500
	(386) 274-1414
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Shawn Demian Kelly
Gender	Male
Speciality	Nurse Practitioner - Family
Location	1667 N Clyde Morris Blvd Ste 2, Daytona Beach, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1174831093
Provider Enumeration Date: 09/14/2010
Last Update Date: 01/26/2024

Medicare PECOS Information:

PECOS PAC ID: 3779723655
Enrollment ID: I20240129001494

Medical Identifiers

Medical identifiers for Mr Shawn Demian Kelly such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1174831093	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	APRN9431397 (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. Mr Shawn Demian Kelly allows following entities to bill medicare on his behalf.

Entity Name	Lakeside Endocrine Associates Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1871041681 PECOS PAC ID: 9133408008 Enrollment ID: O20161116002444

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. Mr Shawn Demian Kelly 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
Mr Shawn Demian Kelly, APRN 1667 N Clyde Morris Blvd Ste 2, Daytona Beach, FL 32117-5500 Ph: (386) 274-1414	Mr Shawn Demian Kelly, APRN 1667 N Clyde Morris Blvd Ste 2, Daytona Beach, FL 32117-5500 Ph: (386) 274-1414

Reviews and Comments

Nurse Practitioner Nurses in Daytona Beach, FL

Ashley Gillette, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 112 Milton Rd, Daytona Beach, FL 32118 Phone: 970-260-0885
Brittany C Gaskin, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1845 Holsonback Dr, Daytona Beach, FL 32117 Phone: 386-274-0500
Charles Wright, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 350 N Clyde Morris Blvd, Daytona Beach, FL 32114 Phone: 386-238-3200 Fax: 386-238-3264
Bruce Harris, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3512 S Atlantic Ave, Daytona Beach, FL 32118 Phone: 386-767-9544
Cloressa Dizney, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 303 N Clyde Morris Blvd, Daytona Beach, FL 32114 Phone: 386-425-4542 Fax: 386-425-7705
Gena Genovese Brennan, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 301 Memorial Medical Pkwy, Daytona Beach, FL 32117 Phone: 386-353-7633 Fax: 386-615-4105
Mrs. Krystal Marie Disantis, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 731 N Clyde Morris Blvd, Daytona Beach, FL 32114 Phone: 786-738-9144 Fax: 877-245-1597

Mr Shawn Demian Kelly, APRN - Medicare Nurse Practitioner in Daytona Beach, FL