Mrs Kay Lynn Southwell, PMHNP-BC,NPC in Mesa, AZ

Mrs Kay Lynn Southwell, PMHNP-BC,NPC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Mesa, Arizona. Her current practice location is 1910 S Stapley Dr Ste 217, Mesa, Arizona. You can reach out to her office (for appointments etc.) via phone at (602) 888-0370.

Mrs Kay Lynn Southwell is licensed to practice in Arizona (license number AP8742) 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 1730320623.

Contact Information

	Mrs Kay Lynn Southwell, PMHNP-BC,NPC
	1910 S Stapley Dr Ste 217, Mesa, AZ 85204-6679
	(602) 888-0370
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Kay Lynn Southwell
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	1910 S Stapley Dr Ste 217, Mesa, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1730320623
Provider Enumeration Date: 03/23/2009
Last Update Date: 09/30/2024

Medicare PECOS Information:

PECOS PAC ID: 2961675558
Enrollment ID: I20160914002452

Medical Identifiers

Medical identifiers for Mrs Kay Lynn Southwell such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1730320623	NPI	-	NPPES
0B56065	Other	AZ	MEDICARE PART B
0B56065	Other	MI	MEDICARE PART B

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP2300X	Nurse Practitioner - Primary Care	4704216251 (Michigan)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	AP8742 (Arizona)	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. Mrs Kay Lynn Southwell allows following entities to bill medicare on her behalf.

Entity Name	Innovative Primary Care Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1669437349 PECOS PAC ID: 9032147095 Enrollment ID: O20050801000274

Entity Name	Kmtrask Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1518413962 PECOS PAC ID: 8921386483 Enrollment ID: O20171212002971

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. Mrs Kay Lynn Southwell 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
Mrs Kay Lynn Southwell, PMHNP-BC,NPC 7156 E Olla Ave, Mesa, AZ 85212-9802 Ph: (810) 919-6247	Mrs Kay Lynn Southwell, PMHNP-BC,NPC 1910 S Stapley Dr Ste 217, Mesa, AZ 85204-6679 Ph: (602) 888-0370

Reviews and Comments

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Mrs Kay Lynn Southwell, PMHNP-BC,NPC - Medicare Nurse Practitioner in Mesa, AZ