Mrs Kelly Shannon Russell, APRN-CNP is a medicare enrolled "Nurse Practitioner - Women's Health" in Allen, Oklahoma. Her current practice location is
200 N Easton, Allen, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(580) 857-1300.
Mrs Kelly Shannon Russell is licensed to practice in Oklahoma (license number 0050643) 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 1538375233.
Provider's Profile
Full Name | Mrs Kelly Shannon Russell |
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Gender | Female |
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Speciality | Nurse Practitioner - Women's Health |
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Location | 200 N Easton, Allen, Oklahoma |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1538375233
- Provider Enumeration Date: 05/16/2007
- Last Update Date: 01/14/2019
Medicare PECOS Information:
- PECOS PAC ID: 1355689290
- Enrollment ID: I20190219000815
Medical Identifiers
Medical identifiers for Mrs Kelly Shannon Russell such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1538375233 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LP2300X | Nurse Practitioner - Primary Care | 0050643 (Oklahoma) | Secondary |
363LW0102X | Nurse Practitioner - Women's Health | 0050643 (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. Mrs Kelly Shannon Russell allows following entities to bill medicare on her behalf.
Entity Name | Rural Health Care Innovations |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1205876752 PECOS PAC ID: 5597780650 Enrollment ID: O20051008000004 |
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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. Mrs Kelly Shannon Russell 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 Kelly Shannon Russell, APRN-CNP 200 Easton Street, Allen, OK 74825 Ph: (580) 857-1300 | Mrs Kelly Shannon Russell, APRN-CNP 200 N Easton, Allen, OK 74825-9713 Ph: (580) 857-1300 |
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