Mrs Susan Elizabeth Kelly, FNP is a medicare enrolled "Nurse Practitioner - Family" in Mooresburg, Tennessee. Her current practice location is
239 Clifford Price Loop, Mooresburg, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(423) 754-9648.
Mrs Susan Elizabeth Kelly is licensed to practice in Tennessee (license number APRN0000025532) 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 1992265003.
Provider's Profile
Full Name | Mrs Susan Elizabeth Kelly |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 239 Clifford Price Loop, Mooresburg, Tennessee |
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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: 1992265003
- Provider Enumeration Date: 03/24/2019
- Last Update Date: 03/24/2019
Medicare PECOS Information:
- PECOS PAC ID: 2668881020
- Enrollment ID: I20221209002058
Medical Identifiers
Medical identifiers for Mrs Susan Elizabeth Kelly such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1992265003 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | APRN0000025532 (Tennessee) | 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 Susan Elizabeth Kelly allows following entities to bill medicare on her behalf.
Entity Name | Instacare Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1275146045 PECOS PAC ID: 5092133538 Enrollment ID: O20200915001708 |
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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 Susan Elizabeth 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 |
Mrs Susan Elizabeth Kelly, FNP 239 Clifford Price Loop, Mooresburg, TN 37811-2337 Ph: (423) 754-9648 | Mrs Susan Elizabeth Kelly, FNP 239 Clifford Price Loop, Mooresburg, TN 37811-2337 Ph: (423) 754-9648 |
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