Mrs Kelli Nicole Bridgman, NP in Port Orange, FL

Mrs Kelli Nicole Bridgman, NP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Port Orange, Florida. Her current practice location is 804 Dunlawton Ave Ste 1, Port Orange, Florida. You can reach out to her office (for appointments etc.) via phone at (386) 767-8584.

Mrs Kelli Nicole Bridgman is licensed to practice in Florida (license number ME73316) 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 1588841977.

Contact Information

	Mrs Kelli Nicole Bridgman, NP
	804 Dunlawton Ave Ste 1, Port Orange, FL 32127-4931
	(386) 767-8584
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Kelli Nicole Bridgman
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	804 Dunlawton Ave Ste 1, Port Orange, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1588841977
Provider Enumeration Date: 01/28/2008
Last Update Date: 03/27/2023

Medicare PECOS Information:

PECOS PAC ID: 1951470764
Enrollment ID: I20210820000634

Medical Identifiers

Medical identifiers for Mrs Kelli Nicole Bridgman such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1588841977	NPI	-	NPPES
448879182A	Medicaid	GA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2200X	Nurse Practitioner - Adult Health	RN164274 (Georgia)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	ME73316 (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. Mrs Kelli Nicole Bridgman allows following entities to bill medicare on her behalf.

Entity Name	Psychiatric Services Of Daytona Plcc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1891373601 PECOS PAC ID: 7012310485 Enrollment ID: O20210722001197

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 Kelli Nicole Bridgman 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 Kelli Nicole Bridgman, NP 1690 Dunn Ave Apt 718, Daytona Beach, FL 32114-1477 Ph: () -	Mrs Kelli Nicole Bridgman, NP 804 Dunlawton Ave Ste 1, Port Orange, FL 32127-4931 Ph: (386) 767-8584

Reviews and Comments

Nurse Practitioner Nurses in Port Orange, FL

Holly Anne Smith, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 870 Dunlawton Ave Ste 210a, Port Orange, FL 32127 Phone: 386-518-3671
Olivia Michelle Miller, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1690 Dunlawton Ave Ste 120, Port Orange, FL 32127 Phone: 386-271-2273 Fax: 386-271-2274
Lynn Ann Howard, ARNP, PMHNP, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 804 Dunlawton Ave, Port Orange, FL 32127 Phone: 386-767-8584 Fax: 386-767-8536
Jay W Butwinick, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1730 Dunlawton Ave Ste 1, Port Orange, FL 32127 Phone: 386-320-3299
Margaret M. Thompson, A.R.N.P., M.S.N Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 735 Dunlawton Ave, Port Orange, FL 32127 Phone: 888-808-0488 Fax: 386-872-4232
Kelly S Kiah, D.N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3800 Woodbriar Trl, Port Orange, FL 32129 Phone: 386-322-4752
Ms. Margaret Leger Ramstad, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1648 Taylor Rd Ste 259, Port Orange, FL 32128 Phone: 386-320-5525 Fax: 386-222-7395

Mrs Kelli Nicole Bridgman, NP - Medicare Nurse Practitioner in Port Orange, FL