Mrs Kelly Teresa Miller, PMHNP-BC in Charlotte, NC

Mrs Kelly Teresa Miller, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Charlotte, North Carolina. Her current practice location is 10420 Park Rd Ste 300, Charlotte, North Carolina. You can reach out to her office (for appointments etc.) via phone at (980) 237-4766.

Mrs Kelly Teresa Miller is licensed to practice in North Carolina (license number 5008017) 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 1215306956.

Contact Information

	Mrs Kelly Teresa Miller, PMHNP-BC
	10420 Park Rd Ste 300, Charlotte, NC 28210-8502
	(980) 237-4766
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Kelly Teresa Miller
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	10420 Park Rd Ste 300, Charlotte, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1215306956
Provider Enumeration Date: 09/23/2015
Last Update Date: 02/09/2022

Medicare PECOS Information:

PECOS PAC ID: 8123329430
Enrollment ID: I20151210001188

Medical Identifiers

Medical identifiers for Mrs Kelly Teresa Miller such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1215306956	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	5008017 (North Carolina)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	5008017 (North Carolina)	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 Teresa Miller allows following entities to bill medicare on her behalf.

Entity Name	Pediatric And Family Behavioral Health Acquisition Group Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1770056038 PECOS PAC ID: 8820419120 Enrollment ID: O20200521002294

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 Teresa Miller 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 Teresa Miller, PMHNP-BC 8200 Prescott Glen Pkwy, Waxhaw, NC 28173-6931 Ph: (704) 641-4885	Mrs Kelly Teresa Miller, PMHNP-BC 10420 Park Rd Ste 300, Charlotte, NC 28210-8502 Ph: (980) 237-4766

Reviews and Comments

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Angela Devincent Booth, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1001 Blythe Blvd, Medical Center Plaza Suite 200, Charlotte, NC 28203 Phone: 704-381-8840

Mrs Kelly Teresa Miller, PMHNP-BC - Medicare Nurse Practitioner in Charlotte, NC